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KMID : 0362720220600100625
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Journal of the Korean Dental Association
2022 Volume.60 No. 10 p.625 ~ p.636
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Differences in Long-term Efficacy of Oral Appliance Therapy for Obstructive Sleep Apnea According to Polysomnographic Phenotypes
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Jo Jung-Hwan
Jang Ji-Hee
Park Ji-Woon
Chung Jin-Woo
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Abstract
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Purpose: The purpose of this study is to evaluate the efficacy of oral appliance therapy for the treatment of obstructive sleep apnea (OSA) according to distinct polysomnographic phenotypes.
Material and Methods: Forty four patients with OSA were evaluated before and after oral appliance therapy through polysomnography along with clinical and radiological examination. Treatment efficacy and change in respiratory parameters were evaluated according to polysomnographic phenotypes based on OSA severity, sleep position dependency and REM sleep relatedness.
Results: Mean age of the patients was 49.8±11.3 years. The apnea-hypopnea index (AHI) value at baseline was 29.0±21.8/h. After a mean treatment duration of 56.6±42.0 months using an oral appliance, the overall AHI had reduced by 44.3±35.4%. Treatment efficacy of oral appliance for OSA was 47.7% with AHI < 10 and 40.9% for AHI >50% reduction. Results were similar regardless of OSA severity. The reduction of AHI and increase of oxygen saturation level was significantly greater in patients with positional OSA than in those with nonpositional OSA. Not-REM-related OSA patients showed significantly greater reduction of AHI and increase in oxygen saturation compared to those with REM-related OSA.
Conclusion: Oral appliance therapy was effective in approximately half of the patients with OSA during a long-term follow-up period. Positional and not-REM-related OSA patients showed higher treatment efficacy and improvement with oral appliance therapy.
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KEYWORD
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Efficacy, Obstructive sleep apnea (OSA), Oral appliance, REM sleep, Sleep position
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