Friedman Score in Relation to Compliance and Treatment Response in Nonsevere Obstructive Sleep Apnea

Abstract

Nonsevere obstructive sleep apnea (OSA) is most often treated with a continuous positive airway pressure (CPAP) device or a mandibular advancement splint (MAS). However, patient compliance with these treatments is difficult to predict. Improvement in apnea-hypopnea index (AHI) is also somewhat unpredictable in MAS treatment. In this study, we investigated the association between Friedman tongue position score (Friedman score) and both treatment compliance and AHI improvement in patients with nonsevere OSA receiving CPAP or MAS treatment. 104 patients with nonsevere OSA were randomly allocated to CPAP or MAS treatment and followed for 12 months. Data were collected through a medical examination, questionnaires, sleep recordings from ambulatory type 3 polygraphic sleep recording devices, and CPAP recordings. Associations between Friedman score, treatment compliance, and AHI improvement were analysed with logistic regression analyses. Friedman score was not associated with treatment compliance (odds ratio [OR]: 0.85, 95% confidence interval [CI]: 0.59-1.23), or AHI improvement (OR: 1.05, 95% CI: 0.62-1.76) in the overall study sample, the CPAP treatment group, or the MAS treatment group. Adjustment for socioeconomic factors, body mass index, and tonsil size did not significantly impact the results. Although Friedman score may predict OSA severity and contribute to the prediction of success in uvulopalatopharyngoplasty, we found no association between Friedman score and treatment compliance in patients with nonsevere OSA receiving CPAP or MAS treatment, nor did we find any association between Friedman score and AHI improvement. Factors other than Friedman score should be considered when deciding whether a patient with nonsevere OSA should be treated with CPAP or MAS.

Effectiveness of remote monitoring and feedback on objective compliance with a mandibular advancement device for treatment of obstructive sleep apnea

“…Objective measures of PAP compliance have recently become part of routine clinical practice, and insurance companies now cover reimbursements for the devices and disposable supplies according to the compliance measured by the PAP device itself (Hevener & Hevener, 2016). In contrast, measurement of compliance to OA therapy has relied on self‐reporting in many studies (Berg et al, 2020; Lo et al, 2021; Pahkala & Suominen, 2021) as well as in routine clinical practice. Lowe et al first presented objective evidence of compliance using a monitor with a temperature sensor (Lowe et al, 2000), and additional studies have since reported objective compliance with OA.…”

“…Objective measures of PAP compliance have recently become part of routine clinical practice, and insurance companies now cover reimbursements for the devices and disposable supplies according to the compliance measured by the PAP device itself (Hevener & Hevener, 2016). In contrast, measurement of compliance to OA therapy has relied on self-reporting in many studies (Berg et al, 2020 and micro-recorder (DentiTrac ® ; Braebon Medical). In this study, a micro-recorder (DentiTrac ® ) embedded into an OA was used to monitor objective compliance with the OA.…”

Machine Learning Identification of Obstructive Sleep Apnea Severity through the Patient Clinical Features: A Retrospective Study

“…Participants aged ≥ 18 years who were referred to our units for sleep respiratory disorders were enrolled and subjected to clinical diagnostic evaluation and consequently phenotyped. A full clinical history of symptoms, such as morning headache and decreased libido, validated questionnaires (ESS), and anatomical or endoscopic scores were collected ( Table 1 ) ( Supplementary File S1–S3 ) [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ].…”

Combined Transoral Robotic Tongue Base Surgery and Palate Surgery in Obstructive Sleep Apnea Syndrome: Modified Uvulopalatopharyngoplasty versus Barbed Reposition Pharyngoplasty

“…Drug-induced sleep endoscopy was performed for all the patients. All patients revealed vellum anterior–posterior collapse over 50% and oropharyngeal lateral 50% collapse, reaching the Friedman grade II of lingual tonsils hypertrophy without epiglottic collapse by drug-induced sleep endoscopy (DISE) under the VOTE grading system [ 20 ]. In addition, all patients underwent PSG, which revealed at least moderate and severe OSA.…”