Long-term obstructive sleep apnea therapy: a 10-year follow-up of mandibular advancement device and continuous positive airway pressure

Autor: Dilyana S Joffe-Sokolova, Julia A. M. Uniken Venema, Aarnoud Hoekema, Boudewijn Stegenga, Johannes H. van der Hoeven, Michiel H. J. Doff, Peter J. Wijkstra
Přispěvatelé: Oral Kinesiology
Rok vydání: 2020
Předmět:
Zdroj: J Clin Sleep Med
Journal of clinical sleep medicine, 16(3), 353-359. MDPI AG
Journal of Clinical Sleep Medicine, 16(3), 353-359. American Academy of Sleep Medicine
Uniken Venema, J A M, Doff, M H J, Joffe-Sokolova, D, Wijkstra, P J, van der Hoeven, J H, Stegenga, B & Hoekema, A 2020, ' Long-term obstructive sleep apnea therapy : A 10-year follow-up of mandibular advancement device and continuous positive airway pressure ', Journal of Clinical Sleep Medicine, vol. 16, no. 3, pp. 353-359 . https://doi.org/10.5664/JCSM.8204
ISSN: 1550-9397
1550-9389
DOI: 10.5664/JCSM.8204
Popis: STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is a sleep-related breathing disorder, commonly managed by either continuous positive airway pressure (CPAP) or a mandibular advancement device (MAD). Long-term follow-up and comparison regarding efficacy of these therapies is scarce. In this study the results of treatment, patient adherence, and satisfaction over a 10-year follow-up of these therapies are reported. METHODS: This is a longitudinal follow-up study taken from a subset of patients initially enrolled in a randomized controlled clinical trial of 103 patients with OSA (51 and 52 patients randomized for MAD and CPAP, respectively). After a 10-year follow-up period, 14 patients using MAD and 17 patients using CPAP could be evaluated for this longitudinal follow-up study. Data were analyzed at baseline, after 3 months and at 1-, 2-, and 10-year follow-up. All 31 patients with OSA underwent polysomnography and self-reported measurements. RESULTS: Polysomnography results showed a favorable outcome of both therapies at 10-year follow-up. At baseline, included patients in both groups did not significantly differ in apnea-hypopnea index (AHI) values. At 10-year follow-up, both the MAD and CPAP groups showed a significant reduction in AHI. At baseline the mean AHI in the MAD group was 31.7 ± 20.6 events/h whereas in the CPAP group it was 49.2 ± 26.1 events/h. At 10-year follow-up the mean AHI in the MAD group was 9.9 ± 10.3 events/h and in the CPAP group it was 3.4 ± 5.4 events/h. Both therapies resulted in a substantial improvement in self-reported neurobehavioral outcomes at 10-year follow-up. CONCLUSIONS: Both CPAP and MAD therapy demonstrate good and stable treatment effects after a 10-year follow-up period. Therefore, when indicated, both therapies are appropriate modalities for the long-term management of OSA. CLINICAL TRIAL REGISTRATION: Registry: Netherlands Trial Register; Name: Management of the Obstructive Sleep Apnea-Hypopnea Syndrome: Oral Appliance versus Continuous Positive Airway Pressure Therapy; Identifier: NL75; URL: https://www.trialregister.nl/trial/75 CITATION: Uniken Venema JAM, Doff MHJ, Joffe-Sokolova D, et al. Long-term obstructive sleep apnea therapy: a 10-year follow-up of mandibular advancement device and continuous positive airway pressure. J Clin Sleep Med. 2020;16(3):353–359.
Databáze: OpenAIRE
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