Abstract
Objective
Although oral appliance therapy is considered a validated treatment for obstructive
sleep apnea, its therapeutic success varies significantly among patients. Drug-induced
sleep endoscopy is often employed in order to identify candidates for upper airway
surgery; however, it remains unknown whether its findings can be associated with success
of oral appliance therapy. This study tested the hypothesis that drug-induced sleep
endoscopy variables can predict the outcome of oral appliance therapy in obstructive
sleep apnea patients.
Methods
Forty-nine obstructive sleep apnea patients [45 men; mean apnea-hypopnea index 25.3 ± 7.5
events/h; mean body mass index 28.2 ± 3.0 kg/m2] underwent drug-induced sleep endoscopy, followed by a one-month of oral appliance
therapy, and subsequently a follow-up polysomnography to assess outcome.
Results
Thirty-three patients (67.3%) were responders and sixteen were non-responders (32.6%).
Non-responders had a higher occurrence of complete or partial circumferential collapse
at velum in comparison with responders. Multivariate logistic regression analysis
revealed that, among baseline clinical and polysomnographic characteristics and sleep
endoscopy findings, the presence of complete circumferential collapse at velum and
increased body mass index were the only independent predictors of oral appliance therapy
failure.
Conclusion
Drug-induced sleep endoscopy can be used to predict a higher likelihood of success
to oral appliance therapy in obstructive sleep apnea patients.
Keywords
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Article Info
Publication History
Published online: August 25, 2020
Accepted:
August 13,
2020
Received:
May 30,
2020
Identification
Copyright
© 2020 Oto-Rhino-Laryngological Society of Japan Inc. Published by Elsevier B.V. All rights reserved.
