Title
Determinants of objective compliance during oral appliance therapy in patients with sleep-disordered breathing : a prospective clinical trialDeterminants of objective compliance during oral appliance therapy in patients with sleep-disordered breathing : a prospective clinical trial
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Research group
Laboratory Experimental Medicine and Pediatrics (LEMP)
Translational Neurosciences (TNW)
Faculteit Geneeskunde
Publication type
article
Publication
Chicago, Ill.,
Subject
Human medicine
Source (journal)
JAMA otolaryngology, head and neck surgery / American Medical Association. - Chicago, Ill., 2013, currens
Volume/pages
141(2015):10, p. 894-900
ISSN
2168-6181
ISI
000362978400004
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
Importance The main reported reasons for discontinuation of oral appliance therapy for sleep-disordered breathing (SDB) are the presence of self-perceived adverse effects and self-appreciated lack of efficacy. However, these conclusions rely only on subjective compliance data. Objective To determine which parameters are correlated with objectively measured data on compliance with oral appliance therapy. Design, Setting, and Participants For 51 outpatients with SDB, a prospective clinical trial using oral appliance therapy was conducted at Antwerp University Hospital from February 7, 2011, to October 8, 2013 (38 [75%] males; mean [SD] age, 49.3 [9.0] years; mean [SD] apnea-hypopnea index, 14.9 [9.3] events per hour of sleep; mean [SD] body mass index [calculated as weight in kilograms divided by height in meters squared], 26.3 [2.8]). Analysis was performed November 5, 2014. Intervention Oral appliance therapy with a custom-made, titratrable mandibular advancement device (OAm). Main Outcomes and Measures Possible correlations were assessed between objective compliance and patients anthropometric characteristics, polysomnographic parameters, and answers to 3 subjective questionnaires (the visual analog scale for snoring, the Epworth Sleepiness Scale, and an adverse effects questionnaire). Results Median oral appliance use was 6.4 hours per night (range, 4.7-7.2 hours per night) at the 3-month follow-up. None of the anthropometric and polysomnographic parameters were correlated with compliance. No correlation was found between objective compliance and reports of excessive daytime sleepiness. However, a significant inverse correlation was found between objective compliance and posttreatment visual analog scale values for snoring (P = .006; ρ = 0.40). In addition, objective compliance was correlated significantly with a more pronounced decrease in socially disturbing snoring (P = .005; ρ = 0.39). The presence of dry mouth was the only adverse effect that was negatively correlated with objective compliance at the 3-month follow-up (P < .05; ρ = 0.31). Conclusions and Relevance Neither the anthropometric and polysomnographic parameters nor reports of excessive daytime sleepiness correlated with compliance during oral appliance therapy. The 2 parameters that were correlated with higher objective compliance during oral appliance therapy were a more pronounced decrease in snoring and the presence of dry mouth during treatment.
Full text (open access)
https://repository.uantwerpen.be/docman/irua/8ee451/128921_2016_11_18.pdf
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