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dc.contributor.authorJOHAL, Aen_US
dc.contributor.authorJahaur, Pen_US
dc.contributor.authorAl-quattan, Fen_US
dc.contributor.authorKassim, Sen_US
dc.contributor.authorMc Cloughlin, Ken_US
dc.date.accessioned2016-11-25T11:45:51Z
dc.date.available2016-11-02en_US
dc.date.issued2016-11-05en_US
dc.date.submitted2016-11-16T15:28:16.762Z
dc.identifier.urihttp://qmro.qmul.ac.uk/xmlui/handle/123456789/17884
dc.description.abstractStudy objectives: Could a clinically safe and reliable compliance measure of mandibular advancement appliance (MAA) therapy demonstrate a high level of therapeutic efficacy, in patients diagnosed with moderate OSAHS. Study design and participants: A long-term prospective observational study was undertaken in which patients with moderate OSAHS and in whom CPAP use had failed, to determine treatment compliance with MAA therapy, after a minimum period of 18 months, using an objective monitor. Treatment outcomes included both objective sleep monitoring and a determination of the therapeutic efficacy based on the calculation of the mean disease alleviation (MDA). Results: Forty-two patients, with moderate OSAHS (mean AHI of 21.0 [+/- 10.3] events/hour) completed the study, at 18–month follow-up. A statistically significant difference (p<0.001; 95%CI 2.76, 3.50) was observed between the objectively recorded use of the MAA appliance (7.13 hours) and the predetermined gold standard level of 4 hours. A highly statistically significant reduction (p<0.001) was observed in follow-up ESS (7.2 +/- 3.3) and AHI (4.7 +/- 3.0) scores, which in turn was evidenced by the calculated therapeutic efficacy of 75.1% (95CI 70.9, 79.2) and a MDA of 70% (95CI 63.7, 76.3). Conclusion: The study demonstrates the safe long-term objective measurement of compliance and comparable levels of therapeutic efficacy for MAA therapy in patients with moderate OSAHS, providing new evidence of the role of MAA therapy as a viable alternative in patients unable to tolerate CPAP.en_US
dc.description.sponsorshipA small charities grant was awarded to help purchase the objective monitoring sensorsen_US
dc.language.isoenen_US
dc.relation.ispartofJournal of Sleep Disorders and Managementen_US
dc.rightsOpen Access by ClinMed International Library is licensed under a Creative Commons Attribution 4.0 International License based on a work at http://clinmedjournals.org/.
dc.subjectObservational studyen_US
dc.subjectmandibular appliancesen_US
dc.subjectsleep apnoeaen_US
dc.subjectcomplianceen_US
dc.titleThe efficacy of mandibular advancement appliances as a treatment alternative to continuous positive airway pressure in moderate OSAHSen_US
dc.typeArticle
dc.rights.holder(c) The Author(s) 2016.
dc.identifier.doi10.23937/2572-4053.1510013en_US
pubs.notesNot knownen_US
pubs.notesOpen access Journalen_US
pubs.publication-statusPublisheden_US
dcterms.dateAccepted2016-11-02en_US


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