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Original Research: Sleep Disorders |

Objectively Measured vs Self-Reported Compliance During Oral Appliance Therapy for Sleep-Disordered BreathingTherapy Compliance for Sleep-Disordered Breathing

Marijke Dieltjens, MBS, Drs; Marc J. Braem, DDS, PhD; Anneclaire V. M. T. Vroegop, MD, PhD; Kristien Wouters, PhD; Johan A. Verbraecken, MD, PhD; Wilfried A. De Backer, MD, PhD; Paul H. Van de Heyning, MD, PhD; Olivier M. Vanderveken, MD, PhD
Author and Funding Information

From the Department of Special Care Dentistry (Drs Dieltjens and Braem), Department of Otolaryngology and Head and Neck Surgery (Drs Vroegop, Van de Heyning, and Vanderveken), Department of Scientific Coordination and Biostatistics (Dr Wouters), Department of Pneumology (Drs Verbraecken and De Backer), and Multidisciplinary Sleep Disorders Center (Drs Verbraecken, De Backer, Van de Heyning, and Vanderveken), Antwerp University Hospital, Edegem; and Faculty of Medicine and Health Sciences (Drs Dieltjens, Braem, Vroegop, Verbraecken, De Backer, Van de Heyning, and Vanderveken), University of Antwerp, Antwerp, Belgium.

Correspondence to: Marijke Dieltjens, MBS, Drs, Department of Special Care Dentistry, Antwerp University Hospital, Wilrijkstr 10, B-2650 Edegem, Belgium; e-mail: Marijke.Dieltjens@uza.be


Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(5):1495-1502. doi:10.1378/chest.13-0613
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Background:  Assessment of the overall therapeutic effectiveness of oral appliance therapy can only be realized through objectively measured compliance. The aims of this study were to assess objectively measured compliance during oral appliance therapy at 1-year follow-up and to compare these data with self-reported use.

Methods:  Fifty-one eligible patients were enrolled in this 1-year prospective clinical study (men, 61%; mean age, 49 ± 10 years; apnea-hypopnea index, 18.0 ± 11.9 events/h sleep; BMI, 26.6 ± 4.1 kg/m2). Objective compliance during oral appliance therapy at 1-year follow-up was assessed with a microsensor thermometer. Subjective compliance was assessed by self-report. Patients with a mean objectively measured use of ≥ 4 h/night on 70% of nights monitored were considered regular users. The mean disease alleviation was calculated as a measure of overall therapeutic effectiveness.

Results:  High agreement between objective and subjective compliance data at 1-year follow-up was reported (intraclass correlation coefficient, 0.8; 95% CI, 0.5-0.9), showing a mean subjective overestimation of 30 min (95% CI, −3.1 to 1.9; P = .02). The discontinuation rate at 1-year follow-up was 9.8%. The objective mean use rate was 6.4 ± 1.7 h/night at 1-year follow-up in continuing users, with a regular use rate of 83%. The mean disease alleviation was 54.9%.

Conclusions:  This study is the first to our knowledge to report the 1-year results of objectively measured compliance during oral appliance therapy. In addition, a high agreement between objective and subjective compliance data were reported, with a mean subjective overestimation of 30 min.

Trial registry:  ClinicalTrials.gov; No.: NCT01284881; URL: www.clinicaltrials.gov

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