Comparison of Adjustable and Fixed Oral Appliances for the Treatment of Obstructive Sleep Apnea
Identifieur interne : 002414 ( Pmc/Curation ); précédent : 002413; suivant : 002415Comparison of Adjustable and Fixed Oral Appliances for the Treatment of Obstructive Sleep Apnea
Auteurs : Christopher J. Lettieri [États-Unis] ; Nathalie Paolino [États-Unis] ; Arn H. Eliasson [États-Unis] ; Anita A. Shah [États-Unis] ; Aaron B. Holley [États-Unis]Source :
- Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine [ 1550-9389 ] ; 2011.
Abstract
To compare the efficacy of adjustable and fixed oral appliances for the treatment of OSA.
Retrospective review of consecutive patients with OSA treated with either adjustable or fixed oral appliances. Polysomnography was conducted before and during therapy. Effective treatment was defined as an apnea-hypopnea index (AHI) < 5 events/h or < 10 events/h with resolution of sleepiness (Epworth < 10). We compared efficacy rates between fixed and adjustable appliances and sought to identify factors associated with greater success.
We included 805 patients, 602 (74.8%) treated with an adjustable and 203 (25.2%) a fixed oral appliances. Among the cohort, 86.4% were men; mean age was 41.3 ± 9.2 years. Mean AHI was 30.7 ± 25.6, with 34.1% having mild (AHI 5-14.9), 29.2% moderate (AHI 15-29.9), and 36.8% severe (AHI ≥ 30) OSA. Successful therapy was significantly more common with adjustable appliances. Obstructive events were reduced to < 5/h in 56.8% with adjustable compared to 47.0% with fixed appliances (p = 0.02). Similarly, a reduction of events to < 10 with resolution of sleepiness occurred in 66.4% with adjustable appliances versus 44.9% with fixed appliances (p < 0.001). For both devices, success was more common in younger patients, with lower BMI and less severe disease.
Adjustable devices produced greater reductions in obstructive events and were more likely to provide successful therapy, especially in moderate-severe OSA. Fixed appliances were effective in mild disease, but were less successful in those with higher AHIs. Given these findings, the baseline AHI should be considered when selecting the type of oral appliance.
Lettieri CJ; Paolino N; Eliasson AH; Shah AA; Holley AB. Comparison of adjustable and fixed oral appliances for the treatment of obstructive sleep apnea.
Url:
DOI: 10.5664/JCSM.1300
PubMed: 22003337
PubMed Central: 3190841
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: Pour aller vers cette notice dans l'étape Curation :002414
Links to Exploration step
PMC:3190841Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Comparison of Adjustable and Fixed Oral Appliances for the Treatment of Obstructive Sleep Apnea</title>
<author><name sortKey="Lettieri, Christopher J" sort="Lettieri, Christopher J" uniqKey="Lettieri C" first="Christopher J." last="Lettieri">Christopher J. Lettieri</name>
<affiliation wicri:level="2"><nlm:aff id="aff1">Pulmonary, Critical Care, and Sleep Medicine, Walter Reed Army Medical Center, Washington, DC</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">District de Columbia</region>
</placeName>
<wicri:cityArea>Pulmonary, Critical Care, and Sleep Medicine, Walter Reed Army Medical Center, Washington</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="aff2">Department of Medicine, Uniformed Services University, Bethesda, MD</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Maryland</region>
</placeName>
<wicri:cityArea>Department of Medicine, Uniformed Services University, Bethesda</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Paolino, Nathalie" sort="Paolino, Nathalie" uniqKey="Paolino N" first="Nathalie" last="Paolino">Nathalie Paolino</name>
<affiliation wicri:level="2"><nlm:aff id="aff3">Department of Medicine, Walter Reed Army Medical Center, Washington, DC</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">District de Columbia</region>
</placeName>
<wicri:cityArea>Department of Medicine, Walter Reed Army Medical Center, Washington</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Eliasson, Arn H" sort="Eliasson, Arn H" uniqKey="Eliasson A" first="Arn H." last="Eliasson">Arn H. Eliasson</name>
<affiliation wicri:level="2"><nlm:aff id="aff1">Pulmonary, Critical Care, and Sleep Medicine, Walter Reed Army Medical Center, Washington, DC</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">District de Columbia</region>
</placeName>
<wicri:cityArea>Pulmonary, Critical Care, and Sleep Medicine, Walter Reed Army Medical Center, Washington</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="aff2">Department of Medicine, Uniformed Services University, Bethesda, MD</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Maryland</region>
</placeName>
<wicri:cityArea>Department of Medicine, Uniformed Services University, Bethesda</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Shah, Anita A" sort="Shah, Anita A" uniqKey="Shah A" first="Anita A." last="Shah">Anita A. Shah</name>
<affiliation wicri:level="2"><nlm:aff id="aff2">Department of Medicine, Uniformed Services University, Bethesda, MD</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Maryland</region>
</placeName>
<wicri:cityArea>Department of Medicine, Uniformed Services University, Bethesda</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Holley, Aaron B" sort="Holley, Aaron B" uniqKey="Holley A" first="Aaron B." last="Holley">Aaron B. Holley</name>
<affiliation wicri:level="2"><nlm:aff id="aff1">Pulmonary, Critical Care, and Sleep Medicine, Walter Reed Army Medical Center, Washington, DC</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">District de Columbia</region>
</placeName>
<wicri:cityArea>Pulmonary, Critical Care, and Sleep Medicine, Walter Reed Army Medical Center, Washington</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="aff2">Department of Medicine, Uniformed Services University, Bethesda, MD</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Maryland</region>
</placeName>
<wicri:cityArea>Department of Medicine, Uniformed Services University, Bethesda</wicri:cityArea>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">22003337</idno>
<idno type="pmc">3190841</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3190841</idno>
<idno type="RBID">PMC:3190841</idno>
<idno type="doi">10.5664/JCSM.1300</idno>
<date when="2011">2011</date>
<idno type="wicri:Area/Pmc/Corpus">002414</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002414</idno>
<idno type="wicri:Area/Pmc/Curation">002414</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002414</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Comparison of Adjustable and Fixed Oral Appliances for the Treatment of Obstructive Sleep Apnea</title>
<author><name sortKey="Lettieri, Christopher J" sort="Lettieri, Christopher J" uniqKey="Lettieri C" first="Christopher J." last="Lettieri">Christopher J. Lettieri</name>
<affiliation wicri:level="2"><nlm:aff id="aff1">Pulmonary, Critical Care, and Sleep Medicine, Walter Reed Army Medical Center, Washington, DC</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">District de Columbia</region>
</placeName>
<wicri:cityArea>Pulmonary, Critical Care, and Sleep Medicine, Walter Reed Army Medical Center, Washington</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="aff2">Department of Medicine, Uniformed Services University, Bethesda, MD</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Maryland</region>
</placeName>
<wicri:cityArea>Department of Medicine, Uniformed Services University, Bethesda</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Paolino, Nathalie" sort="Paolino, Nathalie" uniqKey="Paolino N" first="Nathalie" last="Paolino">Nathalie Paolino</name>
<affiliation wicri:level="2"><nlm:aff id="aff3">Department of Medicine, Walter Reed Army Medical Center, Washington, DC</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">District de Columbia</region>
</placeName>
<wicri:cityArea>Department of Medicine, Walter Reed Army Medical Center, Washington</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Eliasson, Arn H" sort="Eliasson, Arn H" uniqKey="Eliasson A" first="Arn H." last="Eliasson">Arn H. Eliasson</name>
<affiliation wicri:level="2"><nlm:aff id="aff1">Pulmonary, Critical Care, and Sleep Medicine, Walter Reed Army Medical Center, Washington, DC</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">District de Columbia</region>
</placeName>
<wicri:cityArea>Pulmonary, Critical Care, and Sleep Medicine, Walter Reed Army Medical Center, Washington</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="aff2">Department of Medicine, Uniformed Services University, Bethesda, MD</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Maryland</region>
</placeName>
<wicri:cityArea>Department of Medicine, Uniformed Services University, Bethesda</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Shah, Anita A" sort="Shah, Anita A" uniqKey="Shah A" first="Anita A." last="Shah">Anita A. Shah</name>
<affiliation wicri:level="2"><nlm:aff id="aff2">Department of Medicine, Uniformed Services University, Bethesda, MD</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Maryland</region>
</placeName>
<wicri:cityArea>Department of Medicine, Uniformed Services University, Bethesda</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Holley, Aaron B" sort="Holley, Aaron B" uniqKey="Holley A" first="Aaron B." last="Holley">Aaron B. Holley</name>
<affiliation wicri:level="2"><nlm:aff id="aff1">Pulmonary, Critical Care, and Sleep Medicine, Walter Reed Army Medical Center, Washington, DC</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">District de Columbia</region>
</placeName>
<wicri:cityArea>Pulmonary, Critical Care, and Sleep Medicine, Walter Reed Army Medical Center, Washington</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="aff2">Department of Medicine, Uniformed Services University, Bethesda, MD</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Maryland</region>
</placeName>
<wicri:cityArea>Department of Medicine, Uniformed Services University, Bethesda</wicri:cityArea>
</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="2011">2011</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Study Objectives:</title>
<p>To compare the efficacy of adjustable and fixed oral appliances for the treatment of OSA.</p>
</sec>
<sec><title>Methods:</title>
<p> Retrospective review of consecutive patients with OSA treated with either adjustable or fixed oral appliances. Polysomnography was conducted before and during therapy. Effective treatment was defined as an apnea-hypopnea index (AHI) < 5 events/h or < 10 events/h with resolution of sleepiness (Epworth < 10). We compared efficacy rates between fixed and adjustable appliances and sought to identify factors associated with greater success.</p>
</sec>
<sec><title>Results:</title>
<p> We included 805 patients, 602 (74.8%) treated with an adjustable and 203 (25.2%) a fixed oral appliances. Among the cohort, 86.4% were men; mean age was 41.3 ± 9.2 years. Mean AHI was 30.7 ± 25.6, with 34.1% having mild (AHI 5-14.9), 29.2% moderate (AHI 15-29.9), and 36.8% severe (AHI ≥ 30) OSA. Successful therapy was significantly more common with adjustable appliances. Obstructive events were reduced to < 5/h in 56.8% with adjustable compared to 47.0% with fixed appliances (p = 0.02). Similarly, a reduction of events to < 10 with resolution of sleepiness occurred in 66.4% with adjustable appliances versus 44.9% with fixed appliances (p < 0.001). For both devices, success was more common in younger patients, with lower BMI and less severe disease.</p>
</sec>
<sec><title>Conclusions:</title>
<p> Adjustable devices produced greater reductions in obstructive events and were more likely to provide successful therapy, especially in moderate-severe OSA. Fixed appliances were effective in mild disease, but were less successful in those with higher AHIs. Given these findings, the baseline AHI should be considered when selecting the type of oral appliance.</p>
</sec>
<sec><title>Citation:</title>
<p> Lettieri CJ; Paolino N; Eliasson AH; Shah AA; Holley AB. Comparison of adjustable and fixed oral appliances for the treatment of obstructive sleep apnea. <italic>J Clin Sleep Med</italic>
2011;7(5):439-445.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-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="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">22003337</article-id>
<article-id pub-id-type="pmc">3190841</article-id>
<article-id pub-id-type="doi">10.5664/JCSM.1300</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>New Research</subject>
<subj-group><subject>Scientific Investigations</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>Comparison of Adjustable and Fixed Oral Appliances for the Treatment of Obstructive Sleep Apnea</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Lettieri</surname>
<given-names>Christopher J.</given-names>
</name>
<degrees>M.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>Paolino</surname>
<given-names>Nathalie</given-names>
</name>
<degrees>D.O.</degrees>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Eliasson</surname>
<given-names>Arn H.</given-names>
</name>
<degrees>M.D.</degrees>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Shah</surname>
<given-names>Anita A.</given-names>
</name>
<degrees>D.O.</degrees>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Holley</surname>
<given-names>Aaron B.</given-names>
</name>
<degrees>M.D.</degrees>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<aff id="aff1"><label>1</label>
Pulmonary, Critical Care, and Sleep Medicine, Walter Reed Army Medical Center, Washington, DC</aff>
<aff id="aff2"><label>2</label>
Department of Medicine, Uniformed Services University, Bethesda, MD</aff>
<aff id="aff3"><label>3</label>
Department of Medicine, Walter Reed Army Medical Center, Washington, DC</aff>
</contrib-group>
<author-notes><corresp id="cor1">Address correspondence to: Christopher J. Lettieri, M.D., <addr-line>Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Walter Reed Army Medical Center, 6900 Georgia Ave, NW, Washington DC, 20307</addr-line>
<phone>(202) 782-5720</phone>
<fax>(202) 782-9032</fax>
<email>christopher.lettieri@us.army.mil</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><day>15</day>
<month>10</month>
<year>2011</year>
</pub-date>
<volume>7</volume>
<issue>5</issue>
<fpage>439</fpage>
<lpage>445</lpage>
<history><date date-type="received"><month>3</month>
<year>2011</year>
</date>
<date date-type="rev-recd"><month>6</month>
<year>2011</year>
</date>
<date date-type="accepted"><month>6</month>
<year>2011</year>
</date>
</history>
<permissions><copyright-statement>© 2011 American Academy of Sleep Medicine</copyright-statement>
<copyright-year>2011</copyright-year>
</permissions>
<abstract><sec><title>Study Objectives:</title>
<p>To compare the efficacy of adjustable and fixed oral appliances for the treatment of OSA.</p>
</sec>
<sec><title>Methods:</title>
<p> Retrospective review of consecutive patients with OSA treated with either adjustable or fixed oral appliances. Polysomnography was conducted before and during therapy. Effective treatment was defined as an apnea-hypopnea index (AHI) < 5 events/h or < 10 events/h with resolution of sleepiness (Epworth < 10). We compared efficacy rates between fixed and adjustable appliances and sought to identify factors associated with greater success.</p>
</sec>
<sec><title>Results:</title>
<p> We included 805 patients, 602 (74.8%) treated with an adjustable and 203 (25.2%) a fixed oral appliances. Among the cohort, 86.4% were men; mean age was 41.3 ± 9.2 years. Mean AHI was 30.7 ± 25.6, with 34.1% having mild (AHI 5-14.9), 29.2% moderate (AHI 15-29.9), and 36.8% severe (AHI ≥ 30) OSA. Successful therapy was significantly more common with adjustable appliances. Obstructive events were reduced to < 5/h in 56.8% with adjustable compared to 47.0% with fixed appliances (p = 0.02). Similarly, a reduction of events to < 10 with resolution of sleepiness occurred in 66.4% with adjustable appliances versus 44.9% with fixed appliances (p < 0.001). For both devices, success was more common in younger patients, with lower BMI and less severe disease.</p>
</sec>
<sec><title>Conclusions:</title>
<p> Adjustable devices produced greater reductions in obstructive events and were more likely to provide successful therapy, especially in moderate-severe OSA. Fixed appliances were effective in mild disease, but were less successful in those with higher AHIs. Given these findings, the baseline AHI should be considered when selecting the type of oral appliance.</p>
</sec>
<sec><title>Citation:</title>
<p> Lettieri CJ; Paolino N; Eliasson AH; Shah AA; Holley AB. Comparison of adjustable and fixed oral appliances for the treatment of obstructive sleep apnea. <italic>J Clin Sleep Med</italic>
2011;7(5):439-445.</p>
</sec>
</abstract>
<kwd-group><kwd>Oral appliance</kwd>
<kwd>mandibular advancement device</kwd>
<kwd>obstructive sleep apnea</kwd>
<kwd>efficacy</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Santé/explor/EdenteV2/Data/Pmc/Curation
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 002414 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Curation/biblio.hfd -nk 002414 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Wicri/Santé |area= EdenteV2 |flux= Pmc |étape= Curation |type= RBID |clé= PMC:3190841 |texte= Comparison of Adjustable and Fixed Oral Appliances for the Treatment of Obstructive Sleep Apnea }}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Curation/RBID.i -Sk "pubmed:22003337" \ | HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Curation/biblio.hfd \ | NlmPubMed2Wicri -a EdenteV2
![]() | This area was generated with Dilib version V0.6.32. | ![]() |