Does oral appliance efficacy in treating obstructive sleep apnea depend on the appliance specialist's experience?
OSAHS
Obstructive sleep apnea-hypopnea syndrome
Oral appliance
Journal
Sleep & breathing = Schlaf & Atmung
ISSN: 1522-1709
Titre abrégé: Sleep Breath
Pays: Germany
ID NLM: 9804161
Informations de publication
Date de publication:
Mar 2024
Mar 2024
Historique:
received:
09
05
2023
accepted:
16
08
2023
revised:
27
07
2023
pubmed:
7
9
2023
medline:
7
9
2023
entrez:
7
9
2023
Statut:
ppublish
Résumé
In France, oral appliances (OAs) are the first-line treatment for moderate and second-line treatment for severe obstructive sleep apnea-hypopnea syndrome. In general, the sleep specialist refers his/her patient to the appliance specialist for the impressions and the fitting. However, is there a relationship between the volume of activity of the appliance specialist and the efficacy of this device? Our unit includes seven appliance otolaryngology specialists whose activities are highly variable (number of patients varying by a factor of almost 10). Data from a prospective follow-up registry of patients treated with an OA for moderate and severe obstructive sleep apnea-hypopnea syndrome were studied, and differences in outcomes between practitioners in the team were sought. Among 859 patients, OAs significantly reduced the apnea-hypopnea index. Even if the patients were not completely comparable from one practitioner to another, there was a significant heterogeneity in efficacy (complete or partial response of the apnea-hypopnea index and failure of OAs) between practitioners (p = 0.0038; 0.0011; 0.0007 respectively), with better results in practitioners with a higher level of OA activity. The findings suggest that it may be preferable to refer patients to OA practitioners who see a higher volume of patients with moderate or severe obstructive sleep apnea-hypopnea syndrome treated with an OA.
Identifiants
pubmed: 37676348
doi: 10.1007/s11325-023-02908-y
pii: 10.1007/s11325-023-02908-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
555-560Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
Références
Vecchierini MF, Leger D, Laaban JP, Putterman G, Figueredo M, Levy J et al (2008) Efficacy and compliance of mandibular repositioning device in obstructive sleep apnea syndrome under a patient-driven protocol of care. Sleep Med 9:762–769
doi: 10.1016/j.sleep.2007.09.007
pubmed: 17980654
Vecchierini MF, Attali V, Collet JM, d’Ortho MP, El Chater P, Kerbrat JB et al (2016) A custom-made mandibular repositioning device for obstructive sleep apnoea-hypopnoea syndrome: the ORCADES study. Sleep Med 19:131–140
doi: 10.1016/j.sleep.2015.05.020
pubmed: 26364869
Buiret G, Bechara M, Plouin-Gaudon I, Bavozet F, Dancea O, Pujo K et al (2021) Oral appliances may be effective in sleep apnea syndrome beyond classical predictive factors. Laryngoscope 131:E2089–E2096
pubmed: 33605446
Clark GT, Sohn JW, Hong CN (2000) Treating obstructive sleep apnea and snoring: assessment of an anterior mandibular positioning device. J Am Dent Assoc 131:765–771
doi: 10.14219/jada.archive.2000.0275
pubmed: 10860328
Ferguson KA, Cartwright R, Rogers R, Schmidt-Nowara W (2006) Oral appliances for snoring and obstructive sleep apnea: a review. Sleep 29:244–262
doi: 10.1093/sleep/29.2.244
pubmed: 16494093
Ng AT, Gotsopoulos H, Qian J, Cistulli PA (2003) Effect of oral appliance therapy on upper airway collapsibility in obstructive sleep apnea. Am J Respir Crit Care Med 168:238–241
doi: 10.1164/rccm.200211-1275OC
pubmed: 12724125
Serra-Torres S, Bellot-Arcis C, Montiel-Company JM, Marco-Algarra J, Almerich-Silla JM (2016) Effectiveness of mandibular advancement appliances in treating obstructive sleep apnea syndrome: A systematic review. Laryngoscope 126:507–514
doi: 10.1002/lary.25505
pubmed: 26228493
Almeida FR, Tsuiki S, Hattori Y, Takei Y, Inoue Y, Lowe AA (2011) Dose-dependent effects of mandibular protrusion on genioglossus activity in sleep apnoea. Eur Respir J 37:209–212
doi: 10.1183/09031936.00194809
pubmed: 21205716
Santé HAD. Comment prescrire les dispositifs médicaux de traitement du syndrome d’apnées hypopnées obstructives du sommeil chez l’adulte. 2014; Available from: https://www.has-sante.fr/portail/upload/docs/application/pdf/2014-11/sahos_-_fiche_de_bon_usage.pdf .
Clark GT (1998) Mandibular advancement devices and sleep disordered breathing. Sleep Med Rev 2:163–174
doi: 10.1016/S1087-0792(98)90019-3
pubmed: 15310499
Dieltjens M, Vanderveken OM, Heyning PH, Braem MJ (2012) Current opinions and clinical practice in the titration of oral appliances in the treatment of sleep-disordered breathing. Sleep Med Rev 16:177–185
doi: 10.1016/j.smrv.2011.06.002
pubmed: 22033170
El Amrani M, Clement G, Lenne X, Farges O, Delpero JR, Theis D et al (2018) Failure-to-rescue in patients undergoing pancreatectomy: is hospital volume a standard for quality improvement programs? Nationwide Analysis of 12,333 Patients. Ann Surg 268:799–807
doi: 10.1097/SLA.0000000000002945
pubmed: 30048329
El Amrani M, Clement G, Lenne X, Rogosnitzky M, Theis D, Pruvot FR et al (2018) The impact of hospital volume and Charlson Score on postoperative mortality of proctectomy for rectal cancer: a nationwide study of 45,569 patients. Ann Surg 268:854–860
doi: 10.1097/SLA.0000000000002898
pubmed: 30063493
Gooiker GA, Lemmens VE, Besselink MG, Busch OR, Bonsing BA, Molenaar IQ et al (2014) Impact of centralization of pancreatic cancer surgery on resection rates and survival. Br J Surg 101:1000–1005
doi: 10.1002/bjs.9468
pubmed: 24844590
Levaillant M, Marcilly R, Levaillant L, Michel P, Hamel-Broza JF, Vallet B et al (2021) Assessing the hospital volume-outcome relationship in surgery: a scoping review. BMC Med Res Methodol 21:204
doi: 10.1186/s12874-021-01396-6
pubmed: 34627143
pmcid: 8502281
Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K et al (2017) Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med 13:479–504
doi: 10.5664/jcsm.6506
pubmed: 28162150
pmcid: 5337595
Anitua E, Duran-Cantolla J, Almeida GZ, Alkhraisat MH (2017) Minimizing the mandibular advancement in an oral appliance for the treatment of obstructive sleep apnea. Sleep Med 34:226–231
doi: 10.1016/j.sleep.2016.12.019
pubmed: 28228337
Attali V, Vecchierini MF, Collet JM, d’Ortho MP, Goutorbe F, Kerbrat JB et al (2019) Efficacy and tolerability of a custom-made Narval mandibular repositioning device for the treatment of obstructive sleep apnea: ORCADES study 2-year follow-up data. Sleep Med 63:64–74
doi: 10.1016/j.sleep.2019.04.021
pubmed: 31606651
Deane SA, Cistulli PA, Ng AT, Zeng B, Petocz P, Darendeliler MA (2009) Comparison of mandibular advancement splint and tongue stabilizing device in obstructive sleep apnea: a randomized controlled trial. Sleep 32:648–653
doi: 10.1093/sleep/32.5.648
pubmed: 19480232
pmcid: 2675900
Dieltjens M, Braem MJ, Vroegop A, Wouters K, Verbraecken JA, De Backer WA et al (2013) Objectively measured vs self-reported compliance during oral appliance therapy for sleep-disordered breathing. Chest 144:1495–1502
doi: 10.1378/chest.13-0613
pubmed: 23928873
Dieltjens M, Vanderveken OM, Hamans E, Verbraecken JA, Wouters K, Willemen M et al (2013) Treatment of obstructive sleep apnea using a custom-made titratable duobloc oral appliance: a prospective clinical study. Sleep & breathing = Schlaf & Atmung 17:565–572
doi: 10.1007/s11325-012-0721-3
Attali V, Chaumereuil C, Arnulf I, Golmard JL, Tordjman F, Morin L et al (2016) Predictors of long-term effectiveness to mandibular repositioning device treatment in obstructive sleep apnea patients after 1000 days. Sleep Med 27-28:107–114
doi: 10.1016/j.sleep.2016.10.004
pubmed: 27938910
Buiret G (2022) Mandibular advancement devices in patients with severe OSAHS. Rev Mal Respir 39(4):321–327. https://doi.org/10.1016/j.rmr.2021.12.008
Buiret G, Chidiac F (2020) Long-term oral appliances for moderate to severe sleep apnea syndrome tended to lose efficacy. J Sleep Med Dis 6:1112
Chen H, Lowe AA (2013) Updates in oral appliance therapy for snoring and obstructive sleep apnea. Sleep & breathing = Schlaf & Atmung 17:473–486
doi: 10.1007/s11325-012-0712-4
Dieltjens M, Verbruggen AE, Braem MJ, Wouters K, Verbraecken JA, De Backer WA et al (2015) Determinants of objective compliance during oral appliance therapy in patients with sleep-disordered breathing: a prospective clinical trial. JAMA otolaryngology-- head & neck surg 141:894–900
doi: 10.1001/jamaoto.2015.1756
Hamoda MM, Kohzuka Y, Almeida FR (2018) Oral Appliances for the management of OSA: an updated review of the literature. Chest 153:544–553
doi: 10.1016/j.chest.2017.06.005
pubmed: 28624182
de Almeida FR, Lowe AA, Tsuiki S, Otsuka R, Wong M, Fastlicht S et al (2005) Long-term compliance and side effects of oral appliances used for the treatment of snoring and obstructive sleep apnea syndrome. J Clin Sleep Med 1:143–152
doi: 10.5664/jcsm.8978
pubmed: 17561628
Marklund M, Verbraecken J, Randerath W (2012) Non-CPAP therapies in obstructive sleep apnoea: mandibular advancement device therapy. Eur Respir J 39:1241–1247
doi: 10.1183/09031936.00144711
pubmed: 22075487
Mehta A, Qian J, Petocz P, Darendeliler MA, Cistulli PA (2001) A randomized, controlled study of a mandibular advancement splint for obstructive sleep apnea. Am J Respir Crit Care Med 163:1457–1461
doi: 10.1164/ajrccm.163.6.2004213
pubmed: 11371418
Vanderveken OM, Devolder A, Marklund M, Boudewyns AN, Braem MJ, Okkerse W et al (2008) Comparison of a custom-made and a thermoplastic oral appliance for the treatment of mild sleep apnea. Am J Respir Crit Care Med 178:197–202
doi: 10.1164/rccm.200701-114OC
pubmed: 17673699
Gotsopoulos H, Chen C, Qian J, Cistulli PA (2002) Oral appliance therapy improves symptoms in obstructive sleep apnea: a randomized, controlled trial. Am J Respir Crit Care Med 166:743–748
doi: 10.1164/rccm.200203-208OC
pubmed: 12204875
Doff MH, Hoekema A, Wijkstra PJ, van der Hoeven JH, Huddleston Slater JJ, de Bont LG et al (2013) Oral appliance versus continuous positive airway pressure in obstructive sleep apnea syndrome: a 2-year follow-up. Sleep 36:1289–1296
doi: 10.5665/sleep.2948
pubmed: 23997361
pmcid: 3738037
Hoffstein V (2007) Review of oral appliances for treatment of sleep-disordered breathing. Sleep & breathing = Schlaf & Atmung 11:1–22
doi: 10.1007/s11325-006-0084-8
Ahrens A, McGrath C, Hagg U (2010) Subjective efficacy of oral appliance design features in the management of obstructive sleep apnea: a systematic review. Am J Orthod Dentofacial Orthop 138:559–576
doi: 10.1016/j.ajodo.2010.01.030
pubmed: 21055596
Ahrens A, McGrath C, Hagg U (2011) A systematic review of the efficacy of oral appliance design in the management of obstructive sleep apnoea. Eur J Orthod 33:318–324
doi: 10.1093/ejo/cjq079
pubmed: 21239397
Aarab G, Lobbezoo F, Heymans MW, Hamburger HL, Naeije M (2011) Long-term follow-up of a randomized controlled trial of oral appliance therapy in obstructive sleep apnea. Respiration; int rev of thoracic dis 82:162–168