What is the role of tongue-retaining devices (TRD) in the treatment of 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

In one study, only 52% of patients stated that they were using the TRD after 5 years. Of those, 79% wore the TRD more than 4 nights per week. Among nonusers, 47% went back to CPAP, 12% tried another type of OA and were satisfied, and 41% remained untreated.

This subanalysis of what patients who were noncompliant did is informative and instructive for other studies. First, it shows that CPAP may be preferred after another therapy has been tried over time, and, as mentioned, preference is not synonymous with adherence. Second, patients who do not adhere to one treatment do not automatically seek another treatment. Hence, the use of a TRD is not benign, because 41% of those who did not continue TRD treatment did not receive OSA treatment at all for 1-36 months.

This report by the authors was enlightening, because many studies do not go on to ask what alternatives were sought by the patient. Not seeking other treatment is a very important follow-up question to ask in nonresponders to any OSA treatment.


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