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The outcome of oral appliance therapy on position-dependent obstructive sleep apnea : A multicenter randomized controlled trial

Anette M. C. Fransson (Författare), Göran Isacsson (Författare), Eva Nohlert, 1955- (Författare)

URI http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-493006, URN urn:nbn:se:uu:diva-493006, DOI 10.1016/j.ajodo.2021.04.029, Identifikator http://uu.diva-portal.org/smash/get/diva2:1726298/FULLTEXT01 · url

Uppsala universitet Medicinska och farmaceutiska vetenskapsområdet (Utgivare)

utgivning

Elsevier, 2022

är del av

American Journal of Orthodontics and Dentofacial Orthopedics · ISSN 0889-5406

162:3, 386-393

Bidrag, Onlineresurs

Finns online:

http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-493006

ämne

Medical and Health Sciences, Health Sciences, Public Health, Global Health, Social Medicine and Epidemiology, Medicin och hälsovetenskap, Hälsovetenskaper, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi

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Sammanfattning

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.