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

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

OBJECTIVES: 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 multicenter 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 pretreatment baseline and follow-up for OA. Age, sex, BMI, apnea-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.