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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 (Author), Göran Isacsson (Author), Eva Nohlert, 1955- (Author)

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, Identifier http://uu.diva-portal.org/smash/get/diva2:1726298/FULLTEXT01 · url

Uppsala universitet Medicinska och farmaceutiska vetenskapsområdet (Publisher)

publication

Elsevier, 2022

Is part of

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

162:3, 386-393

Component part, Online resource

Available online:

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

Subject

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

More details Cite

Summary

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.