Objectively Measured vs Self-Reported Compliance During Oral Appliance Therapy for Sleep-Disordered Breathing

Dieltjens, Marijke; Braem, M; Vroegop, Anneclaire V.; Wouters, Kristien; Verbraecken, Johan; Backer, Wilfried A. De; Heyning, Paul Van de; Vanderveken, Olivier M.

doi:10.1378/chest.13-0613

Cited by 118 publications

(108 citation statements)

References 40 publications

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“…72 Long-term follow-up found that 89% of participants remained as regular users to MAS at 12 months after treatment. 73 This adherence rate is relatively high compared with CPAP, in which 58% to 78% of patients only are considered regular users. 75,76 …”

Section: Preference and Adherence To Mandibular Advancement Splintsmentioning

confidence: 99%

“…70,71 Recently, thermal microsensors with good storage and readout capability have become commercially available. [72][73][74] The thermal microsensor chip is embedded into MAS, and the temperature readings are used to obtain an objective measure of hours of MAS usage. Initial reports of objective adherence data show a mean daily usage of MAS 3 months after treatment was 6.6 hours per night, with approximately 84% of participants being regular users (4 hours per night and 5 days per week).…”

Section: Preference and Adherence To Mandibular Advancement Splintsmentioning

confidence: 99%

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Mandibular Advancement Splints

Bamagoos

Sutherland

Cistulli

2016

Sleep Medicine Clinics

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Section: Preference and Adherence To Mandibular Advancement Splintsmentioning

confidence: 99%

Section: Preference and Adherence To Mandibular Advancement Splintsmentioning

confidence: 99%

Mandibular Advancement Splints

Bamagoos

Sutherland

Cistulli

2016

Sleep Medicine Clinics

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“…Some reports indicate that generally patients prefer MAS to CPAP [Ferguson et al 2006], while other studies report a similar preference or more preference for CPAP [Sutherland et al 2014]. The rate of suspension after 1 year fluctuates from 10% to 25% of the patients treated with MAS and data on long-term compliance are still scarce [Dieltjens et al 2013]. Indeed, as for other treatments, correct selection of patients is also important for MAS in order to achieve success.…”

Section: Oral Appliancesmentioning

confidence: 99%

Obstructive sleep apnoea syndrome and its management

Spicuzza

Caruso

Maria

2015

Therapeutic Advances in Chronic Disease

245

172

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Abstract:Obstructive sleep apnoea (OSA) is a common disorder characterized by repetitive episodes of nocturnal breathing cessation due to upper airway collapse. OSA causes severe symptoms, such as excessive daytime somnolence, and is associated with a significant cardiovascular morbidity and mortality. Different treatment options are now available for an effective management of this disease. After more than three decades from its first use, continuous positive airway pressure (CPAP) is still recognized as the gold standard treatment. Nasal CPAP (nCPAP) is highly effective in controlling symptoms, improving quality of life and reducing the clinical sequelae of sleep apnoea. Other positive airway pressure modalities are available for patients intolerant to CPAP or requiring high levels of positive pressure. Mandibular advancement devices, particularly if custom made, are effective in mild to moderate OSA and provide a viable alternative for patients intolerant to CPAP therapy. The role of surgery remains controversial. Uvulopalatopharyngoplasty is a well established procedure and can be considered when treatment with CPAP has failed, whereas maxillarmandibular surgery can be suggested to patients with a craniofacial malformation. A number of minimally invasive procedures to treat snoring are currently under evaluation. Weight loss improves symptoms and morbidity in all patients with obesity and bariatric surgery is an option in severe obesity. A multidisciplinary approach is necessary for an accurate management of the disease.

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“…With the advent of objective monitoring, in two prospective small-scale studies, a median use of MAD therapy for 6.4 h/night was reported after 3 months and a mean use of 6.1 h/night after 1 year. 52,53 Approximately 29% to 83% of patients using CPAP are noncompliant.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of the New Generation of Devices for Positional Therapy for Patients With Positional Obstructive Sleep Apnea: A Systematic Review of the Literature and Meta-Analysis

Ravesloot¹,

White

Heinzer

et al. 2017

Journal of Clinical Sleep Medicine

108

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Study Objectives:In approximately 56% to 75% of patients with obstructive sleep apnea (OSA), the frequency and duration of apneas are influenced by body position. This is referred to as position-dependent OSA or POSA. Patients with POSA can be treated with a small device attached to either the neck or chest. These devices-a new generation of devices for positional therapy (PT)-provide a subtle vibrating stimulus that prevents patients adopting the supine position. The objectives of this study were to determine whether PT is effective in improving sleep study variables and sleepiness, and to assess compliance. Methods: A systematic review and meta-analysis. Results: Three prospective cohort studies and four randomized controlled trials were included in this review. Combined data for studies reporting on the effect of PT show that there was a mean difference of 11.3 events/h (54% reduction) in apnea-hypopnea index and 33.6% (84% reduction) in percentage total sleeping time in the supine position. The standardized mean difference for both parameters demonstrated a large magnitude of effect (> 0.8 in both cases). Conclusions: There is strong evidence that the new generation of devices for PT are effective in reducing the apnea-hypopnea index during short-term follow-up. These devices are simple-to-use for patients and clinicians and are reversible. Under study conditions with short-term follow-up, compliance is high; however, long-term compliance cannot be assessed because of lack of reliable data. Additional long-term, high-quality studies are needed to confirm the role of PT as a single or as a combination treatment modality for OSA patients and to assess long-term compliance. Keywords: compliance, meta-analysis, obstructive sleep apnea, positional, positional therapy, systematic review Citation: Ravesloot MJ, White D, Heinzer R, Oksenberg A, Pépin JL. Efficacy of the new generation of devices for positional therapy for patients with positional obstructive sleep apnea: a systematic review of the literature and meta-analysis. J Clin Sleep Med. 2017;13(6):813-824. I NTRO DUCTI O NIn approximately 56% to 75% of patients with obstructive sleep apnea (OSA), the frequency and duration of apneas are influenced by body position.1-5 Various definitions of positiondependent obstructive sleep apnea (POSA) have been applied in literature, but the most common classification system and definition marks a distinction between two groups of patients: positional patients (PP) 6 and nonpositional patients (NPP). 3,4,7In PP, desaturations, cyclic variations in heart rate, loud snoring, and apneas and hypopneas appear almost exclusively in the supine position. 8 Cartwright first described the arbitrary cutoff point of a difference of 50% or more in apnea index between supine and nonsupine positions. In the medical literature many have applied modified versions of Cartwright's criteria. In 1998, Marklund et al. defined supine-dependent sleep apnea as a supine apnea-hypopnea index (AHI) ≥ 10 events/h, together with a lateral AHI < 10 ev...

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Objectively Measured vs Self-Reported Compliance During Oral Appliance Therapy for Sleep-Disordered Breathing

Cited by 118 publications

References 40 publications

Mandibular Advancement Splints

Mandibular Advancement Splints

Obstructive sleep apnoea syndrome and its management

Efficacy of the New Generation of Devices for Positional Therapy for Patients With Positional Obstructive Sleep Apnea: A Systematic Review of the Literature and Meta-Analysis

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