The outcome of oral appliance therapy on position-dependent obstructive sleep apnea: A multicenter randomized controlled trial
2022 (English)In: American Journal of Orthodontics and Dentofacial Orthopedics, ISSN 0889-5406, E-ISSN 1097-6752, Vol. 162, no 3, p. 386-393Article in journal (Refereed) Published
Abstract [en]
INTRODUCTION: This multicenter trial on patients with obstructive sleep apnea (OSA) treated with an oral appliance aimed to determine the effect of sleeping positions.
METHODS: A cohort of 314 patients with OSA were enrolled and evaluated at 8 weeks and 1 year, focusing on treatment effects. At baseline and the 2 follow-ups, new polygraphic registration comparing the proportion of treatment responders without position-dependent OSA (non-position-dependent OSA [non-POSA]) and with POSA was used.
RESULTS: At the 8-week and 1-year follow-up, 205 and 139 patients were included, respectively. The proportion of responders (apnea-hypopnea index [AHI] <10 and/or ≥50% reduction in AHI) was 56% for the non-POSA group and 69% for the POSA group (not significant [NS]). The responders increased at the 1-year follow-up: 68% and 77% for the non-POSA and POSA groups (NS), respectively. The absolute change in AHI in all sleeping positions at 8 weeks was -12.9 (interquartile range, -25.0 to -0.5) in the non-POSA group and -10.5 (interquartile range, -19.9 to -5.3; NS) in the POSA group. However, the decrease in supine AHI was significantly greater among subjects with POSA. In contrast, the decrease in nonsupine AHI was significantly greater in the non-POSA group, an effect that remained at the 1-year follow-up.
CONCLUSIONS: Our hypothesis that subjects with POSA at baseline would have a higher treatment response rate after oral appliance treatment compared with subjects without POSA was rejected. However, those with POSA had a significantly higher supine AHI decrease, and those without POSA had significantly less nonsupine AHI.
Place, publisher, year, edition, pages
Elsevier, 2022. Vol. 162, no 3, p. 386-393
National Category
Dentistry
Identifiers
URN: urn:nbn:se:oru:diva-99013DOI: 10.1016/j.ajodo.2021.04.029ISI: 000896338300020PubMedID: 35562290Scopus ID: 2-s2.0-85130414218OAI: oai:DiVA.org:oru-99013DiVA, id: diva2:1658406
Note
Funding agencies:
Uppsala-Örebro Regional Research Council
Västmanland County Council
Research Committee of Public Dental Service, Region Örebro County, Sweden
2022-05-162022-05-162023-01-05Bibliographically approved