“Obstructive Sleep Apnea: analysis of factors related to long-term adherence to oral appliance therapy”
“Obstructive Sleep Apnea, Oral appliances, Long-term, Adherence”
“Study Objectives: This study aimed to subjective evaluate patients diagnosed with obstructive sleep apnea (OSA), treated with oral appliance therapy (OAT) for more than 10 years. Methods: An electronic questionnaire-based survey was sent to 298 patients with OSA, treated with OAT for more than 10 years. Patients were asked if were still wearing their oral appliance (OA), and then divided into adherent and non-adherent group. Both groups were asked about presence of side effects during the treatment, self-perception improvement of symptons, partner satisfaction, knowledge and concern with untreated consequences of OSA. Statistical significance was defined as p<0.05. Results: 121 (40.6%) patients returned the questionnaire. Main reasons to initiate treament were partner disturbed with snoring (77.6%) and excessive daytime sleepness (66.1%). 54 (44.6%) were still wearing their OA, with a mean time of treatment of 13.2 ± 2.21 years. In non-adherent group, most patients stopped using their OA during the first year of treatment and the main reasons for discontinuing treatment were discomfort and little or no effect. Improvements in sleep quality, daytime sleepness and partner satisfaction were significantly higher (p<0.01) in adherent group. There was a significant association (p<0.001) with unconcern about consequences of untreated OSA and discontinuition of OAT. Most reported side effects were discomfort and tooth pain. Conclusion: Adherence to OAT is still an issue, specially in the long-term. Understanding symptons and side effects, along with ongoing patient education could help to improve adherence to this modality of OSA treatment, improving its outcomes.