Semi-fixed versus fixed oral appliance therapy for obstructive sleep apnea: A randomized crossover pilot study

Area of Science:

• Sleep Medicine
• Dental Sleep Medicine
• Medical Devices

Background:

• Obstructive sleep apnea (OSA) is commonly treated with oral appliances (OAs).
• The choice between semi-fixed and fixed OAs for OSA treatment remains unclear.
• This study addresses the comparative efficacy and patient experience of semi-fixed versus fixed OAs.

Purpose of the Study:

• To compare the efficacy of semi-fixed and fixed oral appliances (OAs) in treating obstructive sleep apnea (OSA).
• To evaluate and compare side effects, specifically temporomandibular joint pain.
• To assess patient preference between semi-fixed and fixed OA designs.

Main Methods:

• A randomized crossover pilot study design was employed.
• Patients with mild to moderate OSA used both semi-fixed and fixed OAs for 4-week periods, separated by a 2-week washout.
• Sleep parameters (Apnea-Hypopnea Index - AHI) and temporomandibular joint pain were assessed, alongside patient preference.

Main Results:

• Both semi-fixed and fixed OAs significantly reduced the Apnea-Hypopnea Index (AHI) compared to baseline.
• No significant difference in AHI reduction was observed between the two OA types.
• Semi-fixed OAs demonstrated superior patient preference and fewer instances of temporomandibular joint pain.

Conclusions:

• Both semi-fixed and fixed oral appliances are effective in managing obstructive sleep apnea.
• Semi-fixed OAs offer advantages in patient comfort and preference.
• Semi-fixed oral appliances may be the preferred treatment choice for OSA patients due to better tolerability.