Accéder directement au contenu Accéder directement à la navigation
Article dans une revue

Oral Appliance Treatment for Obstructive Sleep Apnea: An Update

Abstract :

Oral appliances (OA) have emerged as an alternative to continuous positive airway pressure (CPAP) for obstructive sleep apnea (OSA) treatment. The most commonly used OA reduces upper airway collapse by advancing the mandible (OAm). There is a strong evidence base demonstrating OAm improve OSA in the majority of patients, including some with more severe disease. However OAm are not efficacious for all, with approximately one-third of patients experiencing no therapeutic benefit. OAm are generally well tolerated, although short-term adverse effects during acclimatization are common. Long-term dental changes do occur, but these are for the most part subclinical and do not preclude continued use. Patients often prefer OAm to gold-standard CPAP treatment. Head-to-head trials confirm CPAP is superior in reducing OSA parameters on polysomnography; however, this greater efficacy does not necessarily translate into better health outcomes in clinical practice. Comparable effectiveness of OAm and CPAP has been attributed to higher reported nightly use of OAm, suggesting that inferiority in reducing apneic events may be counteracted by greater treatment adherence. Recently, significant advances in commercially available OAm technologies have been made. Remotely controlled mandibular positioners have the potential to identify treatment responders and the level of therapeutic advancement required in single night titration polysomnography. Objective monitoring of OAm adherence using small embedded temperature sensing data loggers is now available and will enhance clinical practice and research. These technologies will further enhance efficacy and effectiveness of OAm treatment for OSA.

Type de document :
Article dans une revue
Liste complète des métadonnées

https://hal.univ-angers.fr/hal-03276609
Contributeur : Okina Université d'Angers <>
Soumis le : vendredi 2 juillet 2021 - 11:39:03
Dernière modification le : samedi 3 juillet 2021 - 03:07:36

Lien texte intégral

Identifiants

Collections

Citation

Kate Sutherland, Olivier Vanderveken, Hiroko Tsuda, Marie Marklund, Frédéric Gagnadoux, et al.. Oral Appliance Treatment for Obstructive Sleep Apnea: An Update. Journal of Clinical Sleep Medicine, American Academy of Sleep Medicine, 2014, 10 (2), pp.215-227. ⟨10.5664/jcsm.3460⟩. ⟨hal-03276609⟩

Partager

Métriques

Consultations de la notice

9