Prevalence and effect of supine-dependent obstructive sleep apnea on oral appliance therapy
Faculty of Medicine and Health Sciences
Berlin :Springer, 2015
Positional therapy in obstructive sleep apnea / Vries, de, Nico [edit.]; et al.
University of Antwerp
Oral appliance (OA) therapy is a non-invasive treatment option for patients with obstructive sleep apnea (OSA). The most common type of OA therapy prescribed for the treatment of OSA is an oral appliance worn intraorally at night in order to reduce upper airway collapse by protruding the mandible (OAm). In this chapter, we will focus on the effect of supine-dependent OSA (sdOSA) on treatment outcome during OAm therapy, the prevalence of sdOSA before and under OAm therapy and the effect of combination of an OAm and positional therapy. Retrospective analyses of clinical, physiological and polysomnographic variables were performed in literature in order to identify predictors of treatment success with OA therapy. Six studies assessed a significant association between the efficacy of OAm therapy and the presence of sdOSA, whereas the results of two other studies couldnt confirm this finding. In order to evaluate the treatment effect of OAm therapy among patients with or without sdOSA, it can be important to determine the prevalence of sdOSA in the patient population starting OAm therapy. In this restricted patient group, the prevalence of sdOSA at baseline ranged from 27 to 80 %. In addition, up to one third of patients undergoing OAm therapy have sdOSA under OAm therapy. Those patients could probably benefit from additional therapy with a supine-avoidance device. Two studies assessed the efficacy of OA therapy combined with positional therapy showing promising results for this specific combination therapy.