Long-term objective adherence to mandibular advancement device therapy versus continuous positive airway pressure in patients with moderate obstructive sleep apnea

G.E. De Vries, A. Hoekema, J.Q.P.J. Claessen, C. Stellingsma, B. Stegenga, H.A.M. Kerstjens, P. J. Wijkstra

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Study Objectives: Comparable health effects of mandibular advancement device (MAD) and continuous positive airway pressure (CPAP) therapy have been attributed to higher adherence with MAD compared with CPAP therapy. The objective of this study was to make a direct comparison of the objective adherence between MAD and CPAP in patients with moderate obstructive sleep apnea (OSA).
Methods: Adherencewas monitored for 12months in 59 patients with moderate OSA(apnea-hypopnea index 15-30 events/h) as part of a randomized controlled trial. Objective adherence with MAD was assessed using the TheraMon microsensor. Objective adherence with CPAP was assessed using the built-in registration software with readout on SD card. Self-reported adherence with both therapies was assessed using a questionnaire.
Results: Forty patients (68%) completed the study with the therapy to which they were randomly assigned. Median (interquartile range) objective adherence (h/night) in the 3rd month was 7.4 (5.2-8.2) for MAD and 6.8 (5.7-7.6) for CPAP (P =.41), compared to 6.9 (3.5-7.9) with MAD and 6.8 (5.2-7.6) with CPAP (P =.85) in the 12th month. There were no significant changes between the 3rd and 12th month for both MAD (P =.21) and CPAP (P =.46). Changes in adherence were not significantly different between MAD and CPAP (P = .51). Self-reported adherence was significantly higher with MAD than CPAP at all follow-ups. Self-reported adherence with CPAP was lower than objective CPAP adherence at the 6th and 12th month (P = .02).
Conclusions: Objective adherence with MAD and CPAP is comparable and consistent over time. Self-reported adherence is higher with MAD than with CPAP giving rise to interesting discrepancy between objective and self-reported adherence with CPAP.
Original languageEnglish
Pages (from-to)1655-1663
JournalJournal of Clinical Sleep Medicine
Volume15
Issue number11
DOIs
Publication statusPublished - 15 Nov 2019

Funding

The deceased author qualifies as having made an authorship-worthy contribution to the paper. The deceased author knew the paper was being submitted and agreed to that prior to death. This study was funded by SomnoMed Goedegebuure and VitalAire Nederland BV. GEV, AH and PJW report grants from SomnoMed Goedegebuure and from VitalAire Nederland BV, during the conduct of the study. AH reports personal fees for being Medical advisor from Somnomed, Airway Management, and Zephyr Sleep Technologies, outside the submitted work. PJW reports grants and personal fees from Philips, grants and personal fees from RESMED, grants from VIVISOL, personal fees from Synapse, and from Bresotec, outside the submitted work. The other authors report no conflicts of interest.

FundersFunder number
SomnoMed Goedegebuure
VitalAire Nederland BV

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