Treatment Of Obstructive Sleep Apnea Research Articles

Obstructive Sleep Apnea and Short-Term Outcomes After Pediatric Cardiac Surgery.

Obstructive sleep apnea (OSA) has been associated with negative cardiovascular effects and negative outcomes following cardiovascular surgery in the adult population. Our objective was to evaluate if there is a similar association in children. Single center retrospective matched cohort study, we collected data on patients aged 1-18 who were admitted to the cardiac intensive care unit (CICU) between Jan 2012 and Dec 2021. We used a 3:1 propensity score matching for cases not diagnosed with OSA. Primary outcome was a composite variable: "adverse outcome," consisting of prolonged hospital and CICU stay, prolonged duration of mechanical ventilation, need for extracorporeal membrane oxygenation, and death. The study comprised 80 patients diagnosed with OSA and 240 patients without a diagnosis of OSA before cardiac surgery. The median age was 5.3years (IQR 2.7-11.2). There were 184 (57.5%) males, and 102 (31.9%) had chromosomal and genetic abnormalities. There was a difference in "adverse outcome" between the OSA and non-OSA groups [34 (42.50%) vs 68 (28.33%), p = 0.027]. Moreover, bivariate analysis revealed that CICU length of stay, and chromosomal anomalies were statistically different between the groups. By logistic regression the composite variable "adverse outcome" remained associated to the OSA group (p = 0.009) with an adjusted odds ratio (OR) of 4.09 (1.83-9.18), p < 0.001. Children diagnosed with OSA had a higher risk of "adverse outcome" following cardiac surgery. The risk disappeared if the patient had Tonsillectomy and Adenoidectomy before cardiac surgery. Further studies should explore a proactive treatment for OSA in pediatric patients who need cardiac surgery.

The utility of various predictive equations in patients with severe Obstructive Sleep Apnea: a clinical practice viewpoint in settings with limited resources

BackgroundThe continuous positive airway pressure (CPAP) needed for the treatment of obstructive sleep apnea (OSA) can be determined after a manual titration study which is often expensive and time consuming. Hence, different predictive equations were suggested to simplify the treatment of OSA. The purpose of this work was to compare the CPAP identified with manual titration with that calculated using various equations in a cohort of patients with severe OSA.MethodsThis work was conducted on patients diagnosed with severe OSA. Data collected included full medical history, demographic and anthropometric measures, polysomnography results, and the CPAP pressure obtained after manual titration which was further compared to 15 predictive equations retrieved from the literature.ResultsA total of 166 patients [137 (82.5%) males and 29 (17.5%) females] with severe OSA were recruited in the study. Their mean age was 55.91 ± 12.64, and their baseline diagnostic apnea hypopnea index was 71.75 ± 23.70. The mean CPAP manual titration pressure was 11.31 ± 2.9 cmH2O. Non-significant statistical difference was found (p > 0.05) when the mean titration pressure was calculated by Eqs. 2 (11.36 ± 2), 3 (11.55 ± 1.68), 10 (11.51 ± 2.29), 11 (11.14 ± 2.04), and 14 (11.71 ± 2.06), whereas the mean titration pressure calculated by Eqs. 1, 4, 5, 6, 7, 8, 9, 12, 13, and 15 differed significantly from the manual titration pressure (p < 0.05).ConclusionPredictive equations suggested to calculate CPAP pressure, albeit simple and easy to apply, yielded variable results and should be investigated carefully before their use into clinical practice.

Major clinical results of orthognatic surgery in obstructive sleep apnea syndrome: a systematic review

Introduction: Obstructive sleep apnea involves obstruction or narrowing of an individual's airways during sleep and is associated with several comorbidities. Management can be surgical or non-surgical, and Phase II of the Stanford Protocol for surgical management involves maxillomandibular advancement. Objective: To conduct a concise systematic review to present the main considerations and clinical results of orthognathic surgery in obstructive sleep apnea syndrome. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from April to June 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 110 articles were found, 41 articles were evaluated and 23 were included in this systematic review. Considering the Cochrane tool for risk of bias, the global assessment resulted in 28 studies with a high risk of bias and 28 studies that did not meet GRADE. Most studies showed homogeneity in their results, with X2 =88.5% &gt;50%. Maxillomandibular advancement surgery is a successful treatment for obstructive sleep apnea, but there are still concerns about cosmetic results due to the major advances involved. Bimaxillary advancement osteotomy significantly increases oropharyngeal volume and contracted superficial areas, which remain stable between 6 months and 1 year postoperatively.

Case Report: Multidisciplinary Treatment of Obstructive Sleep Apnea and Dental Malocclusion

Case Report: Multidisciplinary Treatment of Obstructive Sleep Apnea and Dental Malocclusion

Case Report: Multidisciplinary Treatment of Obstructive Sleep Apnea and Dental Malocclusion

Case Report: Multidisciplinary Treatment of Obstructive Sleep Apnea and Dental Malocclusion

Impact of lifestyle interventions targeting physical activity and healthy diet on treatment of Obstructive Sleep Apnea (OSA)

Introduction and purpose: Obstructive Sleep Apnea Syndrome (OSAS) is a worldwide prevalent sleep-related medical condition characterised by upper airway collapse, leading to hypoxia and hypercapnia. Excess body weight is the risk factor of OSAS. Lifestyle interventions, particularly targeting weight loss, have emerged as potential management strategies for OSAS. The purpose of this review is to compile the information about the effectiveness of different forms of lifestyle interventions in the treatment of OSA. Brief description of the state of knowledge: While CPAP remains the current “gold standard” treatment of Obstructive Sleep Apnea, it’s not always well-tolerated. Consequently, lifestyle interventions such as dietary modifications, exercise programs, and behavioural therapies have emerged as important components in the management of this disease. The research has shown that these strategies not only reduce the severity of OSA but also improve quality of life. Summary: Lifestyle interventions, including dietary modifications, exercise programs, and behavioral therapies targeting weight loss, have demonstrated promising results in reducing the severity of obstructive sleep apnea (OSA) and alleviating associated symptoms. However, further large-scale, long-term studies are necessary to validate their efficacy and understand their broader impact on OSA management.

Impact of lifestyle interventions targeting physical activity and healthy diet on treatment of Obstructive Sleep Apnea (OSA)

Introduction and purpose: Obstructive Sleep Apnea Syndrome (OSAS) is a worldwide prevalent sleep-related medical condition characterised by upper airway collapse, leading to hypoxia and hypercapnia. Excess body weight is the risk factor of OSAS. Lifestyle interventions, particularly targeting weight loss, have emerged as potential management strategies for OSAS. The purpose of this review is to compile the information about the effectiveness of different forms of lifestyle interventions in the treatment of OSA. Brief description of the state of knowledge: While CPAP remains the current “gold standard” treatment of Obstructive Sleep Apnea, it’s not always well-tolerated. Consequently, lifestyle interventions such as dietary modifications, exercise programs, and behavioural therapies have emerged as important components in the management of this disease. The research has shown that these strategies not only reduce the severity of OSA but also improve quality of life. Summary: Lifestyle interventions, including dietary modifications, exercise programs, and behavioral therapies targeting weight loss, have demonstrated promising results in reducing the severity of obstructive sleep apnea (OSA) and alleviating associated symptoms. However, further large-scale, long-term studies are necessary to validate their efficacy and understand their broader impact on OSA management.

Decisional Needs of Veterans With Mild Traumatic Brain Injury Initiating Treatment for Insomnia Disorder and Obstructive Sleep Apnea.

We sought to elicit key informant (KI) perspectives regarding decisional needs of Veterans with mild traumatic brain injury (mTBI) who are initiating insomnia disorder and obstructive sleep apnea (OSA) treatment within the Veterans Health Administration (VHA) Polytrauma/TBI System of Care (PSC). Specifically, we sought to understand: (1) information regarding treatment options that Veterans with mTBI require in order to make an informed decision; and (2) values used to guide decision-making (ie, personally meaningful aspects of the decision used to compare treatment options). Nationwide VHA PSC sites. Clinicians included VHA providers and policymakers involved in the management of mTBI and/or sleep disorders in the VHA PSC (n =29). Veterans included those with a clinician-confirmed mTBI who received care for insomnia disorder and/or OSA within the past year (n =20). Semi-structured interviews with the 49 KIs were recorded and transcribed verbatim. Themes were identified using a descriptive and interpretive approach to qualitative analysis. Not applicable. Informational needs identified by both KI groups included information regarding outcomes and downsides of treatment, accessible delivery, treatment candidates, description of diagnosis, and level of commitment. Values used to guide decision-making for both insomnia disorder and OSA treatment included benefits, downsides, and availability of treatments. Values used to decide on insomnia treatments alone included time commitment, intrinsic management of sleep, beliefs regarding mental health treatment, and time course of benefit. Values used to decide on OSA treatment alone included intrusiveness of the treatment, appearance, and impact on bed partners. The current study revealed the decisional needs of Veterans with mTBI who are initiating sleep disorder treatment. Findings can inform the development of decision aids and other efforts aimed at promoting patient-centered management of comorbid mTBI and sleep disorders, thereby improving care quality and clinical outcomes.

Efficacy of Barbed Reposition Pharyngoplasty and Uvulopalatopharyngoplasty for Retro Palatal Obstruction

Abstract Background Obstructive sleep apnoea (OSA) is a common problem affecting almost 4% of the population. Although continuous positive airway pressure (CPAP) is considered the standard of care, the patient compliance for long term use is poor. Clinicians have explored surgical options for cure with varying success. Objective To analyze the efficacy of a new modified pharyngoplasty technique (BRP) in comparison with other UPPP techniques to displace the soft palate anteriorly and lateralize the lateral pharyngeal wall in the treatment of OSA. Patients and Methods Types of studies: Systematic review/Meta-analysis. Types of participants: Patients Complain of OSA caused by mild to moderate retropalatal obstruction. Study outcome: efficacy of barbed suture and UPPP operations for retropalatal obstruction, study of success rate. Study of failure rate. Study of complications. Results Regarding Change in ODI Associated with Barbed Sutures, it was found that only 2 studies assessed ODI, and this analysis showed that Weighted mean difference = -23.32 (95% CI = -35.08 to -11.56). There is substantial heterogeneity across studies (Cochran Q test P-value = 0.099, I-squared = 63.33%). In the UPPP procedure, only two studies assessed the ODI, this analysis showed that the weighted mean difference = -14.27 (95% CI = -20.62 to -7.92). There is substantial heterogeneity across studies. Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021. Conclusion Both Barbed reposition pharyngoplasty and Uvulopalatopharyngoplasty techniques were effective in the treatment of cases with obstructive sleep apnoea (OSA). Barbed reposition pharyngoplasty (BRP) can be considered as the gold standard procedure. BRP seem to be more effective than UPPP in a single-level surgical setting. However, being quick, easy to learn and less invasive, BRP is a safe, effective and promising option for treatment of patients with OSA.

A Case for Pilates as Treatment for Obstructive Sleep Apnea

A Case for Pilates as Treatment for Obstructive Sleep Apnea

Diagnosis and treatment of obstructive sleep apnoea in patients with pauses in Holter ECG monitoring: case series

Diagnosis and treatment of obstructive sleep apnoea in patients with pauses in Holter ECG monitoring: case series

Comparison of high flow nasal cannula therapy to nasal oxygen as a treatment for obstructive sleep apnea in infants.

Obstructive sleep apnea (OSA) in infants is treated with low flow oxygen via nasal cannula (NC), CPAP (continous positive airway pressure), or surgery. Literature supports the use of high flow NC (HFNC) in children in the outpatient setting, however there is limited data on the use of HFNC in infants. The purpose of this study was to compare HFNC and low-flow oxygen as treatments for OSA in infants. A prospective pilot study was performed at two institutions. Infants with primarily OSA underwent a 3-4 h sleep study with HFNC titration at 6-14 lpm for OSA, followed by clinical polysomnography (PSG) for oxygen titration (1/8-1 lpm). Infants with primarily central apnea were excluded. Nine infants were enrolled, with a mean age of 1.3 ± 1.7 months. Average apnea hypopnea index (AHI), average obstructive apnea hypopnea index (OAHI) and average central apnea index during the diagnostic PSG was 17.2 ± 7/h, 13.4 ± 5.4/h and 3.7 ± 4.8/h respectively. OSA improved in 44.4% of subjects with HFNC; the mean AHI and OAHI decreased from 15.6 ± 5.65/h and 12.8 ± 4.4/h on diagnostic PSG to 5.12 ± 2.5/h and 4.25 ± 2.5/h on titration PSG. OSA improved universally with low flow oxygen; the mean AHI decreased from 17.2 ± 7/h on diagnostic PSG to 4.44 ± 3.6/h on titration PSG. HFNC reduced OSA in some infants, though low flow oxygen reduced OSA in all subjects. Respiratory instability (high loop gain) in infants may explain why infants responded to low flow oxygen. More studies are needed to determine if HFNC is beneficial in selected groups of infants with OSA.

Factors influencing hospital charges for tonsillectomy to treat obstructive sleep apnea in children.

This study investigates the impact of patient characteristics and demographics on hospital charges for tonsillectomy as a treatment for pediatric obstructive sleep apnea (OSA). The aim is to identify potential disparities in hospital charges and contribute to efforts for equitable access to care. Data from the 2016 Healthcare Cost and Utilization Project (HCUP) Kid Inpatient Database (KID) was analyzed. The sample included 3,304 pediatric patients undergoing tonsillectomy ± adenoidectomy for OSA. Variables such as age, race, length of stay, hospital region, residential location, payer information, and median household income were collected. The primary outcome variable was hospital charge. Statistical analyses, including t-tests, ANOVA, and multiple linear regression, were conducted. Among 3,304 pediatric patients undergoing tonsillectomy for OSA. The average total charges for tonsillectomy were $26,400, with a mean length of stay of 1.70 days. Significant differences in charges were observed based on patient race, hospital region, and payer information. No significant differences were found based on gender, discharge quarter, residential location, or median household income. Multiple linear regression showed race, hospital region, and residential location were significant predictors of total hospital charges. This study highlights the influence of patient demographics and regional factors on hospital charges for pediatric tonsillectomy in OSA cases. These findings underscore the importance of addressing potential disparities in healthcare access and resource allocation to ensure equitable care for children with OSA. Efforts should be made to promote fair and affordable treatment for all pediatric OSA patients, regardless of their demographic backgrounds.

Simultaneous use of GlideScope® in emergency department: A case report

The GlideScope® is a videolaryngoscope manufactured by Verathon Medical (Bothell, WA, USA), now widely used to manage planned or unexpected difficult orotracheal intubation situations. According to the current literature, GlideScope® has been used for surgical procedures involving the tongue base, such as biopsies and radiofrequency treatment of obstructive sleep apnea. We describe a case of dual use of GlideScope for pointed foreign body removal in an emergency department.

Prevalence, Severity, and Treatment of Obstructive Sleep Apnea in Children with Down Syndrome in Qatar.

Patients with Down syndrome (DS) are at risk for sleep disorder breathing (SDB) due to their abnormal craniofacial anatomy, hypotonia, and propensity for obesity. The prevalence and severity of SDB in this population vary between different cohorts due to the multifactorial nature of these patients and the different diagnostic criteria used. We aim to report the prevalence and severity of SDB in the DS population in Qatar. This study is a retrospective review of all patients with genetically confirmed DS who completed a diagnostic polysomnography (PSG) study at Sidra Medicine in Doha, Qatar, which is the only pediatric sleep center in the country, between September 2019 and July 2022. Clinical and PSG data were collected from the patients' electronic medical records. Central and obstructive events were scored according to the American Academy of Sleep Medicine (AASM) criteria. Obstructive sleep apnea (OSA) diagnosis was made based on apnea-hypopnea index (AHI) and defined as AHI>1.5 events/hour.OSA was considered mild if AHI was ≥ 1.5 but < 5, moderate if AHI was ≥ 5 but < 10, and severe if AHI was ≥ 10 events/hour. Diagnosis with central apnea was considered if the central apnea index was > 5 events/hour. Hypoventilation was considered present if end-tidal/transcutaneous carbon dioxide gas was more than 50 mmHg for more than 25% of total sleep time.Multiple regression analysis was performed to evaluate predictors of high AHI and rapid eye movement (REM)-AHI. A total of 80 patients (49 males and 31 females) were included. Median (range) age was 7.3 years (0.9, 21). The mean (range) BMI z-score was 1.7 (-1.3, 4.3). Sixty-five patients were diagnosed with OSA, with a prevalence rate of 81%. OSA was mild in 25 (38.5%) patients, moderate in 15 (23.1%) patients, and severe in 25 (38.5%) patients. Only one patient was diagnosed with central apnea and five patients (6.9%) with alveolar hypoventilation. Multiple regression analysis showed BMI (P = 0.007) and snoring/apnea symptoms (P=0.023) to be predictive of high AHI. No correlation was found between the same variables and REM-AHI. Treatments used for OSA included anti-inflammatory medications in 37 (46%) patients, tonsillectomy/adenoidectomy in 13 (16.5%) patients, and positive airway pressure support in 10 (15%) patients. Our patient population with DS had a high prevalence of OSA comparable to other reported cohorts. High BMI and symptoms of snoring are predictive of OSA.

Identifying the optimal STOP-Bang screening score for obstructive sleep apnea among bariatric surgery patients

BackgroundUndiagnosed obstructive sleep apnea (OSA) increases the risk of perioperative complications in bariatric patients. Validated screening methods exist, but are not specific to patients with severe obesity. ObjectivesDetermine the ideal OSA screening tool for bariatric surgery patients balancing accuracy and cost-effectiveness. SettingUniversity Hospital. MethodsBariatric surgery patients from January 2018 to September 2023 were identified from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. For patients with a STOP-Bang score of ≥4 referred for polysomnogram additional variables were collected from the electronic medical record. The Berlin Score was retrospectively calculated. ResultsOut of 484 patients who underwent bariatric surgery, 167 (34.5%) had a STOP-Bang score ≥4. The receiver operating characteristic (ROC) curve for STOP-Bang scores ≥4 had an area under the curve (AUC) of 78.5% for predicting OSA and 83.7% for OSA requiring treatment (Apnea Hypopnea Index [AHI] ≥ 15), compared to Berlin Scores’ AUC of 80.7% and 88.6%, respectively. A STOP-Bang score of 4 had a sensitivity of 55.6% and specificity of 36.8%, while a score of 5 had 29.3% and 66.2%, respectively. A Berlin Score of 3 had a sensitivity of 47.5% and specificity of 69.1%, with 30 patients (44.1%) starting OSA treatment. Thirty-five patients (21%) experienced a delay in insurance submission, averaging 41.5 days, related to OSA workup. ConclusionThe Berlin questionnaire outperforms STOP-Bang in predicting OSA requiring treatment. Raising the polysomnography referral score from STOP-Bang ≥4 to ≥5 or utilizing a Berlin Score of ≥3, may alleviate resource burden, reduce costs, and expedite medical optimization for bariatric surgery.

Identification of quality-of-life clusters by the Quebec sleep questionnaire in sleep apnea patients.

Patients with obstructive sleep apnea (OSA) may present different symptoms. The clinical importance of symptom clustering is supported by the difference in the incidence of cardiovascular diseases between hypersomnolent and non-hypersomnolent sleep apnea patients. The objective of this study was to determine if quality-of-life clusters could be identified from the Quebec Sleep Questionnaire (QSQ) in OSA patients. Latent class analysis was used to identify clusters in a multivariate analysis of dichotomic variables (presence or absence of symptoms) for each item the QSQ obtained from 147 patients who fulfilled the questionnaire during its validation and subsequent trials (75.5% males, age: 53 ± 11 years, body mass index (BMI): 30.4 ± 4.7 kg/m2, apnea/hypopnea index (AHI): 31.3 ± 14.8/h). Three clusters were identified. Quality of life was preserved in patients of cluster 1 (20.4% of patients). Patients of cluster 2 (32.6% of patients) had a moderately impaired quality of life, mainly due to daytime somnolence and poor sleep quality. Patients with impaired quality of life (cluster 3, 46.9% of patients) had an important impact in every domain of the QSQ with the highest sleepiness and daytime symptom impairments. Gender, BMI, and AHI did not differ between the three clusters. In conclusion, different quality-of-life clusters can be identified from the QSQ in sleep apnea patients. These clusters are similar to those reported previously. Further studies are needed to validate these clusters in larger and independent cohorts, to evaluate how they respond to OSA treatment, and their relationship with incident outcomes.

An overview on the role of epiglottis in obstructive sleep apnoea

Obstructive sleep apnoea (OSA) is common sleep disorder with its multimodal effect on health. OSA, if untreated can lead to various cardiovascular, cerebrovascular, psychological, cognitive as well as sexual morbidities. Continuous positive airway pressure (CPAP) device is considered as the gold standard in the treatment of OSA. Epiglottic collapse (EC) in OSA has evolved an important factor in the management of OSA as the CPAP may worsen the sleep apnoea. EC in itself is classified into primary or secondary, partial or complete, anteroposterior or lateral. Epiglottic collapse is considered as one of the causes for poor adherence to CPAP devices. There are newer diagnostic modalities to diagnose and distinguish primary and secondary epiglottic collapse of which interventional drug induced sleep endoscopy plays a viable and important role. CPAP still serves as a primary treatment modality for multilevel OSA with EC. Surgical treatment modalities for EC is aimed at improving the compliance of CPAP as well as for relieving the obstruction. Surgical options primarily include epiglottectomy, glossoepiglottopexy, epiglottis stiffening operations.

Surgical treatment for obstructive sleep apnea prevents arrhythmic events: a nationwide population-based study

Abstract Background/Introduction Obstructive sleep apnoea (OSA) is a well-established risk factor for the development and exacerbation of cardiac arrhythmias. Continuous positive airway pressure therapy is recommended as the primary non-invasive treatment for OSA. However, suboptimal patient compliance remains a common challenge. Purpose This study explores the benefits of surgery in reducing the occurrence of arrhythmias associated with OSA. The study aims to investigate the impact of surgery in managing OSA-associated arrhythmias. Methods Data from the Korean Health Insurance, from January 2009 to December 2020, were retrospectively compiled and analysed to investigate the clinical outcomes of 359,851 individuals with OSA. Propensity score matching (PSM) at a 1:4 ratio was employed to compare patients who underwent surgery with those who did not. A final cohort of 117,665 participants (85.4% men, aged 60 years old or younger: 94.2%) was established, with 23,533 having undergone surgery for OSA and 94,132 receiving non-surgical management. Over a five-year follow-up period, the occurrence rates of atrial fibrillation (AF), premature beats (premature atrial contractions or premature ventricular contractions), ventricular arrhythmias, sudden cardiac arrest, atrioventricular block, and sinus node dysfunction were evaluated. Results Across the six types of arrhythmias, the cohort that underwent surgery for OSA consistently exhibited a lower incidence of arrhythmias than the non-surgical cohort. In the PSM analysis, a statistically significant reduction in the incidence of AF, premature beats, and sudden cardiac arrest was observed in groups of patients who underwent surgery for OSA. Among those who developed AF, the group that underwent surgery for OSA had a fivefold higher incidence than the non-surgical group (hazard ratio [HR] 5.384, 95% confidence interval [CI] 3.459-8.381). The incidence of premature beats was more than four times higher in the non-surgical group (HR 4.284, 95% CI 2.96-6.177, p&amp;lt;0.0001), and sudden arrest was more than 24x higher in the non-surgical group (HR 24.089, 95% CI 3.348-173.312). Conclusion This study suggests a potential causative relationship between OSA and arrhythmias. Additionally, surgical intervention for OSA may be considered an effective strategy for preventing arrhythmias in young patients. Further clinical research is warranted to validate and refine these observations.Figure 1Figure 2

Gender differences in oral appliance treatment of obstructive sleep apnea.

Although overall success rates for treating obstructive sleep apnea (OSA) with an oral appliance (OA) are high, they are significantly higher among females. To verify published data, the study's purpose was to evaluate a participant sample after one year of OA use. The primary outcome was treatment response, with responders defined as having an apnea-hypopnea index (AHI) < 10 at follow-up and/or reduced by ≥50% of baseline. Secondary measures were from standardized questionnaires. A sample of 314 participants, predominately with moderate-to-severe OSA, were enrolled and instructed to use an OA every night. At baseline and one-year follow-up, polygraphic recordings and questionnaires, including sleepiness (measured using the Epworth sleepiness scale) and quality-of-life (measured using the Functional Outcomes of Sleep Questionnaire), were collected. Among the 314 participants, 192 completed the one-year evaluation: 51 females (27%) and 141 males (73%). Overall, OA treatment resulted in 78% and 77% responders among females and males, respectively. Neither the difference in improvement nor the absolute change in AHI differed significantly based on gender, at any OSA severity level. There were no significant gender differences in sleepiness or quality of life. Treatment-related adverse reactions were more common among females. Both females and males with OSA respond well to OA therapy, with nonsignificant gender differences in outcomes. Thus, the hypothesis that females respond better to OA treatment is rejected.