‘High efficacy’ with mandibular advancement device in new moderate to severe OSA
Click Here to Manage Email Alerts
Key takeaways:
- Apnea-hypopnea index scores were reduced after 3 months of mandibular advancement device use.
- Those with severe obstructive sleep apnea demonstrated more improvement with the device.
WASHINGTON — For patients with new moderate to severe obstructive sleep apnea, mandibular advancement device therapy reduced disorder severity, according to an abstract presented at the American Thoracic Society International Conference.
“Continuous positive airway pressure (CPAP) is often recommended as first-line treatment option for patients with moderate to severe obstructive sleep apnea (OSA),” Marijke Dieltjens, PhD, postdoctoral fellow at Research Foundation Flanders, and colleagues wrote. “Mandibular advancement device (MAD) therapy is frequently seen as second-line when CPAP is discontinued.”
In a current trial of 130 patients with moderate to severe OSA, Dieltjens and colleagues are studying how MAD therapy performs as a first-line treatment option, and polysomnographic and adherence data from patients who have received the therapy for 3 months were presented at ATS.
Researchers tracked patients’ adherence to their titratable MAD (ProSomnus EVO Sleep and Snore Device, ProSomnus Sleep Technologies) through an active thermomicrosensor (Theramon, MC Technology GmbH) that was stored within the treatment device, according to the abstract.
Of the total cohort, 3-month data were reported for 50 patients (median age, 48 years; 88% men; median BMI, 28.1 kg/m2; median obstructive apnea/hypopnea index, 24.7 events per hour), but three had compliance failure and one “was lost to follow-up,” leaving 46 patients (n = 31 with moderate OSA; n = 15 with severe OSA).
After 3 months of treatment with a MAD, researchers observed an overall AHI score of 9.1 events per hour, which was significantly lower than the baseline overall AHI score of 27.2 events per hour (P < .05).
According to the abstract, this therapy helped 39 patients (85%) achieve an AHI of less than 15 events per hour. Further, a 50% or greater reduction in AHI and achievement of less than 20 events per hour was found in 78% of patients.
When assessing changes with MAD by OSA severity, those with severe OSA showed a greater reduction in median AHI at 3 months than those with moderate OSA (74.2% vs. 57.3%).
Between severity groups, researchers found similar percentages of patients who achieved an AHI of less than 15 events per hour (moderate OSA, 84% vs. severe OSA, 87%). However, when assessing the prevalence of patients who achieved 50% or greater reductions in AHI and less than 20 events per hour, a greater proportion of patients with severe OSA reached these measures compared with patients with moderate OSA (100% vs. 65%).
When evaluating adherence to the MAD, 6 hours per night was the mean use duration. Notably, a use duration of more than 5 hours per night was observed in 75% of 36 patients, according to the abstract.
“In this ongoing clinical trial, MAD therapy as a first-line treatment option showed a high efficacy, especially in severe OSA patients, combined with high patients’ adherence,” Dieltjens and colleagues wrote.