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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Oral Appliance Treatment for Obstructive Sleep Apnea: An Update</title>
<author><name sortKey="Sutherland, Kate" sort="Sutherland, Kate" uniqKey="Sutherland K" first="Kate" last="Sutherland">Kate Sutherland</name>
<affiliation><nlm:aff id="aff1">Centre for Sleep Health and Research, Department of Respiratory Medicine, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff2">NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS), University of Sydney and Woolcock Institute of Medical Research, Sydney, Australia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Vanderveken, Olivier M" sort="Vanderveken, Olivier M" uniqKey="Vanderveken O" first="Olivier M." last="Vanderveken">Olivier M. Vanderveken</name>
<affiliation><nlm:aff id="aff3">Department of Otolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff4">Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tsuda, Hiroko" sort="Tsuda, Hiroko" uniqKey="Tsuda H" first="Hiroko" last="Tsuda">Hiroko Tsuda</name>
<affiliation><nlm:aff id="aff5">General Oral Care, Kyushu University Hospital, Fukuoka, Japan</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Marklund, Marie" sort="Marklund, Marie" uniqKey="Marklund M" first="Marie" last="Marklund">Marie Marklund</name>
<affiliation><nlm:aff id="aff6">Department of Orthodontics, Faculty of Medicine, Umea University, Umea Sweden</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gagnadoux, Frederic" sort="Gagnadoux, Frederic" uniqKey="Gagnadoux F" first="Frederic" last="Gagnadoux">Frederic Gagnadoux</name>
<affiliation><nlm:aff id="aff7">LUNAM University, Angers, France</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff8">Department of Respiratory Diseases, Angers University Hospital, Angers, France</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff9">INSERM U1063, Angers, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kushida, Clete A" sort="Kushida, Clete A" uniqKey="Kushida C" first="Clete A." last="Kushida">Clete A. Kushida</name>
<affiliation><nlm:aff id="aff10">Stanford University, Stanford, CA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Cistulli, Peter A" sort="Cistulli, Peter A" uniqKey="Cistulli P" first="Peter A." last="Cistulli">Peter A. Cistulli</name>
<affiliation><nlm:aff id="aff1">Centre for Sleep Health and Research, Department of Respiratory Medicine, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff2">NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS), University of Sydney and Woolcock Institute of Medical Research, Sydney, Australia</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">24533007</idno>
<idno type="pmc">3899326</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899326</idno>
<idno type="RBID">PMC:3899326</idno>
<idno type="doi">10.5664/jcsm.3460</idno>
<date when="2014">2014</date>
<idno type="wicri:Area/Pmc/Corpus">002E90</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002E90</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Oral Appliance Treatment for Obstructive Sleep Apnea: An Update</title>
<author><name sortKey="Sutherland, Kate" sort="Sutherland, Kate" uniqKey="Sutherland K" first="Kate" last="Sutherland">Kate Sutherland</name>
<affiliation><nlm:aff id="aff1">Centre for Sleep Health and Research, Department of Respiratory Medicine, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff2">NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS), University of Sydney and Woolcock Institute of Medical Research, Sydney, Australia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Vanderveken, Olivier M" sort="Vanderveken, Olivier M" uniqKey="Vanderveken O" first="Olivier M." last="Vanderveken">Olivier M. Vanderveken</name>
<affiliation><nlm:aff id="aff3">Department of Otolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff4">Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tsuda, Hiroko" sort="Tsuda, Hiroko" uniqKey="Tsuda H" first="Hiroko" last="Tsuda">Hiroko Tsuda</name>
<affiliation><nlm:aff id="aff5">General Oral Care, Kyushu University Hospital, Fukuoka, Japan</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Marklund, Marie" sort="Marklund, Marie" uniqKey="Marklund M" first="Marie" last="Marklund">Marie Marklund</name>
<affiliation><nlm:aff id="aff6">Department of Orthodontics, Faculty of Medicine, Umea University, Umea Sweden</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gagnadoux, Frederic" sort="Gagnadoux, Frederic" uniqKey="Gagnadoux F" first="Frederic" last="Gagnadoux">Frederic Gagnadoux</name>
<affiliation><nlm:aff id="aff7">LUNAM University, Angers, France</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff8">Department of Respiratory Diseases, Angers University Hospital, Angers, France</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff9">INSERM U1063, Angers, France</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kushida, Clete A" sort="Kushida, Clete A" uniqKey="Kushida C" first="Clete A." last="Kushida">Clete A. Kushida</name>
<affiliation><nlm:aff id="aff10">Stanford University, Stanford, CA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Cistulli, Peter A" sort="Cistulli, Peter A" uniqKey="Cistulli P" first="Peter A." last="Cistulli">Peter A. Cistulli</name>
<affiliation><nlm:aff id="aff1">Centre for Sleep Health and Research, Department of Respiratory Medicine, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff2">NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS), University of Sydney and Woolcock Institute of Medical Research, Sydney, Australia</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine</title>
<idno type="ISSN">1550-9389</idno>
<idno type="eISSN">1550-9397</idno>
<imprint><date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p>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 (OA<sub>m</sub>
). There is a strong evidence base demonstrating OA<sub>m</sub>
improve OSA in the majority of patients, including some with more severe disease. However OA<sub>m</sub>
are not efficacious for all, with approximately one-third of patients experiencing no therapeutic benefit. OA<sub>m</sub>
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 OA<sub>m</sub>
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 OA<sub>m</sub>
and CPAP has been attributed to higher reported nightly use of OA<sub>m</sub>
, suggesting that inferiority in reducing apneic events may be counteracted by greater treatment adherence. Recently, significant advances in commercially available OA<sub>m</sub>
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 OA<sub>m</sub>
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 OA<sub>m</sub>
treatment for OSA.</p>
<sec><title>Citation:</title>
<p>Sutherland K; Vanderveken OM; Tsuda H; Marklund M; Gagnadoux F; Kushida CA; Cistulli PA; on behalf of the ORANGE-Registry. Oral appliance treatment for obstructive sleep apnea: an update. <italic>J Clin Sleep Med</italic>
2014;10(2):215-227.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="review-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Clin Sleep Med</journal-id>
<journal-id journal-id-type="iso-abbrev">J Clin Sleep Med</journal-id>
<journal-id journal-id-type="publisher-id">JCSM</journal-id>
<journal-title-group><journal-title>Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine</journal-title>
</journal-title-group>
<issn pub-type="ppub">1550-9389</issn>
<issn pub-type="epub">1550-9397</issn>
<publisher><publisher-name>American Academy of Sleep Medicine</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24533007</article-id>
<article-id pub-id-type="pmc">3899326</article-id>
<article-id pub-id-type="doi">10.5664/jcsm.3460</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review Articles</subject>
</subj-group>
</article-categories>
<title-group><article-title>Oral Appliance Treatment for Obstructive Sleep Apnea: An Update</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Sutherland</surname>
<given-names>Kate</given-names>
</name>
<degrees>Ph.D.</degrees>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
<xref ref-type="corresp" rid="cor1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Vanderveken</surname>
<given-names>Olivier M.</given-names>
</name>
<degrees>M.D., Ph.D.</degrees>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
<xref ref-type="aff" rid="aff4"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tsuda</surname>
<given-names>Hiroko</given-names>
</name>
<degrees>Ph.D.</degrees>
<xref ref-type="aff" rid="aff5"><sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Marklund</surname>
<given-names>Marie</given-names>
</name>
<degrees>Ph.D.</degrees>
<xref ref-type="aff" rid="aff6"><sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gagnadoux</surname>
<given-names>Frederic</given-names>
</name>
<degrees>M.D., Ph.D.</degrees>
<xref ref-type="aff" rid="aff7"><sup>7</sup>
</xref>
<xref ref-type="aff" rid="aff8"><sup>8</sup>
</xref>
<xref ref-type="aff" rid="aff9"><sup>9</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kushida</surname>
<given-names>Clete A.</given-names>
</name>
<degrees>M.D., Ph.D., F.A.A.S.M.</degrees>
<xref ref-type="aff" rid="aff10"><sup>10</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Cistulli</surname>
<given-names>Peter A.</given-names>
</name>
<degrees>M.D., Ph.D.</degrees>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<on-behalf-of>on behalf of the ORANGE-Registry (Oral Appliance Network on Global Effectiveness)</on-behalf-of>
<aff id="aff1"><label>1</label>
Centre for Sleep Health and Research, Department of Respiratory Medicine, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia</aff>
<aff id="aff2"><label>2</label>
NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS), University of Sydney and Woolcock Institute of Medical Research, Sydney, Australia</aff>
<aff id="aff3"><label>3</label>
Department of Otolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium</aff>
<aff id="aff4"><label>4</label>
Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium</aff>
<aff id="aff5"><label>5</label>
General Oral Care, Kyushu University Hospital, Fukuoka, Japan</aff>
<aff id="aff6"><label>6</label>
Department of Orthodontics, Faculty of Medicine, Umea University, Umea Sweden</aff>
<aff id="aff7"><label>7</label>
LUNAM University, Angers, France</aff>
<aff id="aff8"><label>8</label>
Department of Respiratory Diseases, Angers University Hospital, Angers, France</aff>
<aff id="aff9"><label>9</label>
INSERM U1063, Angers, France</aff>
<aff id="aff10"><label>10</label>
Stanford University, Stanford, CA</aff>
</contrib-group>
<author-notes><corresp id="cor1">Address correspondence to: Dr. Kate Sutherland, <addr-line>Centre for Sleep Health & Research, Department of Respiratory Medicine, University of Sydney, Level 8, Royal North Shore Hospital, Pacific Highway, St. Leonards, NSW, 2065 Australia</addr-line>
<phone>61 2 9926 5542</phone>
<email>kate.sutherland@sydney.edu.au</email>
</corresp>
</author-notes>
<pub-date pub-type="epub"><day>15</day>
<month>2</month>
<year>2014</year>
</pub-date>
<volume>10</volume>
<issue>2</issue>
<fpage>215</fpage>
<lpage>227</lpage>
<history><date date-type="received"><month>3</month>
<year>2013</year>
</date>
<date date-type="rev-recd"><month>10</month>
<year>2013</year>
</date>
<date date-type="accepted"><month>11</month>
<year>2013</year>
</date>
</history>
<permissions><copyright-statement>© 2014 American Academy of Sleep Medicine</copyright-statement>
<copyright-year>2014</copyright-year>
</permissions>
<abstract><p>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 (OA<sub>m</sub>
). There is a strong evidence base demonstrating OA<sub>m</sub>
improve OSA in the majority of patients, including some with more severe disease. However OA<sub>m</sub>
are not efficacious for all, with approximately one-third of patients experiencing no therapeutic benefit. OA<sub>m</sub>
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 OA<sub>m</sub>
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 OA<sub>m</sub>
and CPAP has been attributed to higher reported nightly use of OA<sub>m</sub>
, suggesting that inferiority in reducing apneic events may be counteracted by greater treatment adherence. Recently, significant advances in commercially available OA<sub>m</sub>
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 OA<sub>m</sub>
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 OA<sub>m</sub>
treatment for OSA.</p>
<sec><title>Citation:</title>
<p>Sutherland K; Vanderveken OM; Tsuda H; Marklund M; Gagnadoux F; Kushida CA; Cistulli PA; on behalf of the ORANGE-Registry. Oral appliance treatment for obstructive sleep apnea: an update. <italic>J Clin Sleep Med</italic>
2014;10(2):215-227.</p>
</sec>
</abstract>
<kwd-group><kwd>Obstructive sleep apnea</kwd>
<kwd>oral appliance</kwd>
<kwd>mandibular advancement</kwd>
<kwd>adherence</kwd>
<kwd>effectiveness</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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