Continuous Positive Airway Pressure-Mandibular Advancement Device Combination Therapy for Moderate-to-Severe...

Area of Science:

• Sleep Medicine
• Respiratory Medicine
• Medical Devices

Background:

• Obstructive sleep apnea (OSA) is a common condition characterized by repeated airway collapse during sleep.
• Auto-adjusting positive airway pressure (APAP) is a standard treatment, but patient compliance can be a significant challenge.
• Noncompliance to APAP therapy is linked to poorer health outcomes and reduced quality of life.

Purpose of the Study:

• To evaluate if adding a mandibular advancement device (MAD) to APAP therapy improves patient compliance.
• To assess secondary outcomes including APAP pressure, daytime sleepiness, apnea-hypopnea index (AHI), and mask leaks.

Main Methods:

• A pilot study involving 13 participants diagnosed with moderate-to-severe OSA who were noncompliant with APAP.
• Participants used a MAD in conjunction with their prescribed APAP therapy.
• Data collected included APAP compliance, APAP pressure, Epworth Sleepiness Scale (ESS) scores, AHI, and mask leak data via ResMed AirView software.

Main Results:

• APAP compliance significantly increased by a mean of 23.1% (p=0.015) after adding MAD.
• Subjective daytime sleepiness, measured by ESS, significantly decreased by a mean of 1.4 points (p=0.027).
• No significant changes were observed in APAP pressure, AHI, or mask leak.

Conclusions:

• Combining APAP with a MAD is an effective strategy to improve APAP compliance in noncompliant OSA patients.
• This combination therapy also leads to a significant reduction in daytime sleepiness.
• APAP-MAD therapy presents a viable option for enhancing treatment adherence and patient outcomes in moderate-to-severe OSA.