Tracking Pulse Oximeter Findings Before, During and After Titration of Mandibular Advancement Devices for Patients with Moderate and Severe Obstructive Sleep Apnea
Abstract
Obstructive Sleep Apnea (OSA) is a sleep-related breathing disorder that impacts quality of life and operational readiness and increases the risk of long term health consequences. Military veterans are four times more likely to be diagnosed with OSA compared to the general population. Treatment typically includes the use of a continuous positive airway pressure (CPAP) machine which requires patient tolerability and compliance. An option for OSA management is oral appliance therapy. The Mandibular Advancement Device (MAD) maintains an open upper airway by moving the lower jaw and tongue forward to prevent tissue collapse and airway obstruction. Currently, MAD treatment is guided by patient reported symptom improvement but little objective data is available to determine success. This pilot study evaluated 1) the association of objective oxygenation levels with perceived sleep quality and stress, 2) the feasibility of home pulse oximetry nightly with MAD titration, and 3) the efficacy of pulse oximetry to guide MAD titration. Methods: Participants were active duty personnel newly diagnosed with OSA. Prior to consent, potential participants were evaluated at the Orofacial Pain Center for eligibility. A custom-made MAD was titrated over a period of 4-8 weeks. Before, during, and after titration, a portable pulse oximeter was worn nightly to capture continuous oxygenation levels. Jaw comfort, stress, sleep quality, and MAD adherence were assessed daily. Once maximum tolerable MAD titration was achieved, participants completed a second sleep study to assess MAD efficacy. Results: By the end of the study, all subjects showed a significant decrease in oxygen desaturation index (ODI). Comparing pre and posttreatment polysomnography, 75% of subjects had a reduced apnea-hypopnea index (AHI) and 100 of subjects showed improved sleep efficiency.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 01, 2018
- Accession Number
- AD1132099
Entities
People
- Abigail L. Schmidt