What were the findings of an AASM review of oral appliance (OA) therapy for obstructive sleep apnea (OSA)?

Updated: Sep 15, 2020
  • Author: Himanshu Wickramasinghe, MD, MBBS; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

A review of the literature by the American Sleep Disorders Association (ASDA) indicated the following findings [188] :

  • Overall, 51% of patients studied achieved an RDI of less than 10 with OA therapy.

  • Of patients who had a pretreatment RDI of greater than 20, 39% continued to have an RDI above this level despite OA therapy. At least 1 randomized controlled trial demonstrated that OAs have better success rates in patients with mild OSA (81%) than in those with moderate (60%) or severe (25%) OSA.

  • Continuous adjustment or replacement, as needed, improves success rates with OAs in the long term.

  • No patient characteristics predicted success with OA therapy.

  • No particular OA had any advantages over the others studied.

  • Some patients have an increase in AHI with OA treatment.

  • Endpoints assessed in the studies of OAs varied and included an RDI of less than 10, an RDI of less than 20, or a greater than 50% reduction in the AHI. This variation made the comparison of results difficult. Furthermore, many studies did not stratify patients by severity of OSA.

  • OAs were more likely to be successful in patients with low BMIs, at a young age, with a small neck circumference, with a short soft palate, or with a small oropharynx and in treating positional OSA, as based on retrospective data analysis.


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