The success rate of oral appliances based on multiple criteria according to obstructive sleep apnoea severity, BMI and age: A large multicentre study

Kentaro Okuno; Akifumi Furuhashi; Shuhei Nakamura; Hiroshi Suzuki; Takehiro Arisaka; Hitoshi Taga; Masataka Tamura; Haruto Katahira; Minoru Furuhata; Chisato Iida

doi:10.1111/joor.13046

The success rate of oral appliances based on multiple criteria according to obstructive sleep apnoea severity, BMI and age: A large multicentre study

J Oral Rehabil. 2020 Sep;47(9):1178-1183. doi: 10.1111/joor.13046. Epub 2020 Jul 20.

Authors

Kentaro Okuno^{1

2

3}, Akifumi Furuhashi⁴, Shuhei Nakamura⁵, Hiroshi Suzuki⁶, Takehiro Arisaka⁷, Hitoshi Taga⁸, Masataka Tamura⁹, Haruto Katahira¹⁰, Minoru Furuhata^{11

12}, Chisato Iida¹³

Affiliations

¹ Division for Oral and Facial Disorders, Osaka University Dental Hospital, Suita-shi, Osaka, Japan.
² Department of Geriatric Dentistry, Osaka Dental University, Hirakata-shi, Osaka, Japan.
³ Center for Dental Sleep Medicine, Osaka Dental University Hospital, Chuo-ku, Osaka, Japan.
⁴ Department of Oral and Maxillofacial Surgery, Aichi Medical University, Nagakute-shi, Aichi, Japan.
⁵ Dental Clinic for Sleep Disorders (Apnea and Snoring), Oral and Maxillofacial Rehabilitation, University Hospital of Dentistry, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.
⁶ Division of Oral Function and Rehabilitation, Department of Oral Health Science, Nihon University School of Dentistry at Matsudo, Matsudo-shi, Chiba, Japan.
⁷ Ota Memorial Sleep Center, Sleep Surgery Center, Kawasaki-shi, Kanagawa, 210-0024, Japan.
⁸ Dentistry and Oral Surgery, JR Tokyo General Hospital, Shibuya-ku, Tokyo, Japan.
⁹ Department of Dentistry and Maxillo-facial Surgery, Komatsu Hospital, Neyagawa-shi, Osaka, Japan.
¹⁰ Katahira Dental Clinic, Shibuya-ku, Tokyo, Japan.
¹¹ Furuhata Sleep-disordered Breathing Research Institute, Furuhata Dental Clinic, Minato-ku, Tokyo, Japan.
¹² Snore & Sleep Apnea Treatment Center, Nippon Dental University Hospital Internal Medicine, Chiyoda-ku, Tokyo, Japan.
¹³ Iida Dental Clinic, Soka-chi, Saitama, Japan.

PMID: 32632924
DOI: 10.1111/joor.13046

Abstract

Background: The efficacy of oral appliance (OA) varies greatly in patients with obstructive sleep apnoea (OSA).

Objective(s): The purpose of this cross-sectional study was to investigate the success rate of OA for OSA patients.

Methods: This study was based on a cross-sectional multicentre survey of OA therapy for the management of OSA called the JAMS (Japanese Cross-sectional Multicenter Survey) Study performed at 10 medical institutions. A total of 442 patients fulfilled the selection criteria, which patients had worn OA, and undergone overnight polysomnography to assess both the pre-treatment baseline and follow-up for OA. Age, sex, BMI and apnoea-hypopnea index (AHI) at the time of diagnosis and follow-up for OA were extracted.

Results: After OA treatment, the mean AHI decreased from 22.6 ± 13.8 to 10.0 ± 10.2/h, and the mean rate of decrease in the AHI was 52.5 ± 38.4%. Regarding the success rate to OA therapy, criterion 1 (AHI < 5/h), criterion 2 (AHI < 10/h), criterion 3 (AHI < 15/h) and criterion 4 (AHI reduction rate ≥ 50%) accounted for 33.5, 66.3, 80.5 and 63.3%, respectively. The success rate of OA treatment decreased according to the increase in OSA severity, obesity level (higher BMI) and older age.

Conclusions: This study revealed the treatment success rate of OA on multiple criteria according to OSA severity, BMI and age. It may support for the clinician to make a decision on the OSA management.

Keywords: Multicenter survey; Obstructive sleep apnoea (OSA); Oral appliance (OA).

Publication types

Multicenter Study

MeSH terms

Aged
Body Mass Index
Cross-Sectional Studies
Humans
Polysomnography
Sleep Apnea, Obstructive*
Treatment Outcome

Grants and funding

001/the research grant of the Japanese Academy of Dental Sleep Medicine