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KMID : 0355220080330040305
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Journal of Korean Academy Oral Medicine
2008 Volume.33 No. 4 p.305 ~ p.316
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Variables Affecting Long-Term Compliance of Oral Appliance for Snoring
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Lee Jun-Youp
Hur Yun-Kyung
Choi Jae-Kap
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Abstract
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The mandibular advancement device (MAD) has been used to help manage snoring and obstructive sleep apnea. The aims of this study were to specify the demographic and clinical characteristics of the patients receiving long-term treatment with MAD and to quantify the compliance with and side effects of the use of the device. Of 103 patients who were treated with MAD for at least one full year after delivery date, 49 were able to be contacted with telephone and complete follow-up questionnaires were obtainable. They were telephoned to determine whether they were still using the device. If not, they were asked when and why they stopped using it. Patients were also asked how much effectiveness of the MAD in decreasing snoring and how much they and their bed-partners were satisfied with the MAD therapy. The initial respiratory disturbance indices and pre-treatment snoring frequency and intensity were obtained from the medical records of initial visit. All the data were compared between users and nonusers.
The results were as follows:
1. Of 49 patients 25 are still using the device, but 24 stopped using it. Among nonusers nobody stopped wearing the device within first 1 month, but 37.5% of nonusers stopped wearing it in the following 6 months, and another 4.2% before the end of the first year.
2. The one-year compliance of the MAD therapy was 79.59%.
3. There were no significant differences in mean age, mean body mass index, and gender distribution between users group and nonusers group.
4. There was no significant difference in mean respiratory disturbance index at initial visit between users group and nonusers group.
5. There was no significant difference in pre-treatment snoring frequency and intensity between users group and nonusers group.
6. The degree of decrease in snoring with use of MAD was significantly higher in the users when compared to nonusers.
7. Patient’s overall satisfaction with treatment outcome was significantly higher in the users when compared to nonusers.
8. Bed partner’s satisfaction with treatment outcome tended to be higher in the users when compared to nonusers.
9. The most frequent reasons why patients discontinued wearing the MAD were: jaw pain (25%), dental pain (20.83%), broken appliance (20.83%), hassle using (16.67%), lost weight (8.3%), dental work (8.3%), no or little effect (4.17%), sleep disturbance (4.27).
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KEYWORD
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Snoring, Obstructive sleep apnea, Mandibular advancement device, Long-term compliance
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