Continuous Positive Airway Pressure-Mandibular Advancement Device Combination Therapy for Moderate-to-Severe Obstructive Sleep Apnea: A Preliminary Study

Thyagaseely Sheela Premaraj, Jacob Stadiem, Shyamaly Arya Premaraj, Charles R. Davies, Matthew Dennis, John J. Harrington

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objectives The purpose of this pilot study was to determine whether compliance to auto-adjusting positive airway pressure (APAP) improves with the addition of a mandibular advancement device (MAD). Secondary outcome measures included were APAP pressure, subjective daytime sleepiness, apnea-hypopnea index (AHI), and mask leaks. Setting and Sample Population Participants included were diagnosed with moderate-to-severe obstructive sleep apnea (OSA) and became noncompliant to prescribed APAP. Thirteen participants with a mean age of 61.6 years were recruited for this study. Materials and Methods All participants were given a MAD to use with their APAP. Parameters measured included APAP pressure, AHI, mask leak reported via ResMed AirViewTM software, and self-reported daytime sleepiness (Epworth Sleepiness Scale [ESS]). A paired two-sample for mean t -test was performed to determine significance. Results The mean difference of pre- and postintervention APAP compliance was 23.1%, which was statistically significant (p = 0.015). The mean APAP air pressures were unchanged. The difference between pre- and postintervention mean ESS scores was 1.4 and was statistically significant (p = 0.027). The mean difference between pre- and postintervention AHI values and mask leak showed no significant difference. Conclusion This study showed that combination of APAP-MAD therapy, for patients with moderate-to-severe OSA who were noncompliant to APAP use, significantly increased compliance with APAP therapy, and significantly decreased the daytime sleepiness of participants.

Original languageEnglish (US)
Pages (from-to)749-755
Number of pages7
JournalEuropean Journal of Dentistry
Volume16
Issue number4
DOIs
StatePublished - Oct 2022

Keywords

  • Epworth Sleepiness Scale scores
  • auto-adjusting positive airway pressure
  • mandibular advancement device
  • obstructive sleep apnea

ASJC Scopus subject areas

  • General Dentistry

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