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The Success of Oral Appliance Therapy Based on Symptom-Driven Titration

Mil Med. 2022 Aug 20:usac248. doi: 10.1093/milmed/usac248. Online ahead of print.


STUDY OBJECTIVE: Obstructive sleep apnea (OSA) is a chronic condition that could lead to debilitating and sometimes life-threatening consequences. Oral appliance therapy (OAT) is effective in providing a conservative, nonsurgical treatment option for patients diagnosed with mild-to-moderate OSA. The primary goal of this study is to describe a symptom-based titration protocol and determine if the patients can be effectively managed with oral appliances (OAs).

METHOD: A retrospective chart review of patients who were treated with OAs was analyzed for the management of OSA. Patients were self-titrated for symptomatic improvement before posttreatment titration sleep studies were conducted.

RESULTS: Our study has found that 87.5% of the test population was successfully managed with OAs after overnight titration. Seventy-five percentage of the patients were titrated to Apnea-Hypopnea Index (AHI) < 5 with an average of 79.6% reduction from the baseline. Statistical studies showed that patients’ body mass index and age at baseline polysomnogram studies significantly influenced the reduction in AHI achieved, whereas the baseline AHI did not show any significant correlation.

CONCLUSION: Oral appliance therapy (OAT) can be a reliable treatment modality to treat OSA, and performing a separate overnight posttreatment titration study further ensures its effectiveness. Furthermore, OAT can be an effective treatment modality even for moderate-to-severe OSA with posttreatment titration.

PMID:35986605 | DOI:10.1093/milmed/usac248

By Nevin Manimala

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