Oral appliances for the treatment of obstructive sleep apnea in patients with low C-PAP compliance: a long-term case series.

Cranio : the journal of craniomandibular practice

PubMedID: 25252763

Marchese-Ragona R, Manfredini D, Mion M, Vianello A, Staffieri A, Guarda-Nardini L. Oral appliances for the treatment of obstructive sleep apnea in patients with low C-PAP compliance: a long-term case series. Cranio. 2014;32(4):254-9.
OBJECTIVES
To assess the effectiveness of mandibular advancement devices (MADs) for the treatment of obstructive sleep apnea syndrome (OSAS) over a long-term follow-up in patients non-compliant with continuous positive airway pressure (CPAP) and to identify potential predictive factors of response to MADs.

METHODS
Fifteen OSAS patients were enrolled. Apnea-hypopnea index (AHI) and daytime sleepiness were assessed at baseline and at the end of follow-up. Potential baseline predictors of treatment effectiveness were assessed.

RESULTS
AHI and Epworth Sleepiness Scale (ESS) scores improved significantly with MADs. Sixty per cent of patients were 'responders', of whom 33% were 'full responders'. Sixty-seven per cent of patients showed total compliance. No correlations between the potential predictors and the response to MAD therapy were found.

DISCUSSION
Effectiveness of MAD therapy was shown over a long-term follow-up in OSAS patients with low compliance to CPAP. Efforts to identify predictive success factors fell short.