0
Sleep Disorders |

Does Therapeutic Continuous Positive Airway Pressure Predict Success With an Oral Appliance in the Treatment of Obstructive Sleep Apnea

John Park, MD; Julie Williams, PA-C; Julie Johnson, RN; Kevin Reid, DMD; Kannan Ramar, MD
Author and Funding Information

Mayo Clinic, Rochester, MN


Chest. 2013;144(4_MeetingAbstracts):978A. doi:10.1378/chest.1705070
Text Size: A A A
Published online

Abstract

SESSION TITLE: CPAP for OSA

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, October 27, 2013 at 03:00 PM - 04:00 PM

PURPOSE: While continuous positive airway pressure (CPAP) is the gold standard treatment for obstructive sleep apnea (OSA), compliance remains suboptimal. Oral appliance (OA) is an acceptable alternate to CPAP in those with mild OSA (apnea-hypopnea index [AHI] < 15/hr of sleep). Pressure requirement from CPAP is usually lower in mild OSA. Rather than OSA severity, we therefore, hypothesized that lower therapeutic CPAP requirement would better predict favorable response to OA.

METHODS: We retrospectively collected data on all subjects who underwent a diagnostic and therapeutic polysomnogram (PSG), subsequent oral appliance therapy, and a follow up PSG or an overnight oximetry between 2006 and 2011. Residual AHI or oxygen desaturation index (ODI) was used to assess response to therapy.

RESULTS: Of the 123 subjects with an average age of 55.3 ± 12.2 years, 60 were male. Average body mass index was 29.5 ± 5.4 kg/m2 with an average neck circumference of 38.8 ± 3.7 cm. Eighty subjects (65%) who required CPAP ≤ 7 cm H2O had resultant AHI/ODI of 4.7 ± 6.6 with their OA, whereas the remaining who required pressures > 7 cm H2O had resultant AHI/ODI of 7.4 ± 6.6. Among those who required CPAP ≤ 7 cm H2O, 30% of the subjects had baseline AHI > 15. Of these 24, 54% had resultant AHI/ODI < 5 while 79% had resultant AHI/ODI < 10 on the OA. Eighty-two subjects who had baseline AHI <15 had resultant AHI/ODI of 4.5 ± 4.7. Of these 82 subjects, 72% had residual AHI/ODI < 5. Subjects with baseline AHI < 15 and final CPAP of ≤ 7 cm H2O, had residual AHI/ODI of 3.63 ± 3.5. Eighty-two percent in this group had resultant AHI/ODI < 5.

CONCLUSIONS: Therapeutic CPAP requirement ≤ 7 cm H2O to treat OSA seems to have some predictive value in determining OA success. Therapeutic pressure combined with baseline AHI < 15 seem to better predict OA success than either pressure requirement or baseline AHI.

CLINICAL IMPLICATIONS: Combination of factors seem to better predict success of OA in treatment of OSA.

DISCLOSURE: The following authors have nothing to disclose: John Park, Julie Williams, Julie Johnson, Kevin Reid, Kannan Ramar

No Product/Research Disclosure Information


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Guidelines
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543