0511 An observational retrospective study of the efficacy of oral appliance therapy (OAT) in treating obstructive sleep apnea (OSA)

Abstract

Abstract Introduction Obstructive sleep apnea (OSA) affects approximately 15-30% of males and 10-15% of females in North America. While positive airway pressure (PAP) therapy remains the standard in the treatment of OSA, oral appliance therapy (OAT) has emerged as a viable non-invasive alternative. However, there are limited data on OAT efficacy published, and therefore many sleep clinicians question its efficacy. We conducted a 14-month single-center consecutive chart review to evaluate OAT efficacy. Methods A manual chart review was performed for records from 11/1/2020 to 12/10/2022. Potential charts were identified in the electronic health record by searching for prescriptions for OAT and orders for home sleep apnea tests (HSAT). If there was a test performed after the prescription was written, the chart was reviewed manually for previous test results and verified that post-OAT testing was conducted. Extracted information included age, BMI, gender, pre-OAT HSAT apnea-hypopnea index (AHI), and post-OAT HSAT AHI. The 4% desaturation criteria for AHI was used in accordance with current Medicare guidelines. A paired t-test was performed after ensuring there were no outliers and a normal distribution. Results There were 10 patients included in the analysis: 6 women, 4 men. The average age was 61.1 years (95% CI 49.9-72.3), and average BMI was 28.9 (95% CI 253-32.4). Prior to intervention, 2 patients had moderate OSA with the rest mild (average pre-OAT AHI 13). After OAT device, 4 patients had mild OSA and the rest did not have residual OSA (average post-OAT AHI 4). The results of the paired t-test showed that the mean AHI was statistically significantly different between the two groups (t=-4.54 with df=9, p=0.0014). The mean difference was -8.1 with 95% confidence interval for the true difference in the population mean AHI of -12.1, -4.06. Conclusion The results demonstrate efficacy of OAT in treating OSA. Clinicians should consider OAT as both primary and secondary therapy for mild-to-moderate OSA. Support (if any) N/A