Mandibular advancement device use in obstructive sleep apnea: ORCADES study 5-year follow-up data
STUDY OBJECTIVES: Mandibular advancement devices (MADs) are an alternative to continuous positive airway pressure for the management of obstructive sleep apnea (OSA). The ORthèse d’avanCée mAndibulaire dans le traitement en DEuxième intention du SAHOS sévère (ORCADES) study is investigating the long...
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Online Access: | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8656912/ http://www.ncbi.nlm.nih.gov/pubmed/34165074 https://doi.org/10.5664/jcsm.9308 |
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ftpubmed:oai:pubmedcentral.nih.gov:8656912 2023-05-15T18:50:51+02:00 Mandibular advancement device use in obstructive sleep apnea: ORCADES study 5-year follow-up data Vecchierini, Marie-Françoise Attali, Valérie Collet, Jean-Marc d'Ortho, Marie-Pia Goutorbe, Frederic Kerbrat, Jean-Baptiste Leger, Damien Lavergne, Florent Monaca, Christelle Monteyrol, Pierre-Jean Mullens, Eric Pigearias, Bernard Martin, Francis Khemliche, Hauria Lerousseau, Lionel Meurice, Jean-Claude 2021-08-01 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8656912/ http://www.ncbi.nlm.nih.gov/pubmed/34165074 https://doi.org/10.5664/jcsm.9308 en eng American Academy of Sleep Medicine http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8656912/ http://www.ncbi.nlm.nih.gov/pubmed/34165074 http://dx.doi.org/10.5664/jcsm.9308 © 2021 American Academy of Sleep Medicine J Clin Sleep Med Scientific Investigations Text 2021 ftpubmed https://doi.org/10.5664/jcsm.9308 2022-08-07T00:37:32Z STUDY OBJECTIVES: Mandibular advancement devices (MADs) are an alternative to continuous positive airway pressure for the management of obstructive sleep apnea (OSA). The ORthèse d’avanCée mAndibulaire dans le traitement en DEuxième intention du SAHOS sévère (ORCADES) study is investigating the long-term effectiveness of MAD therapy in patients with OSA who refused or were intolerant of continuous positive airway pressure. Five-year follow-up data are presented. METHODS: Data were available in 172 of 331 patients treated with a custom-made computer-aided design/computer-aided manufacturing biblock MAD (Narval CC; ResMed, Saint-Priest, France). The primary end point was treatment success (≥50% decrease in apnea-hypopnea index from baseline). RESULTS: Five-year treatment success rates were 52% overall and 25%, 52%, and 63%, respectively, in patients with mild, moderate, or severe OSA. This reflects a decline over time vs 3–6 months (79% overall) and 2 years (68%). Rates declined in all patient subgroups but to the greatest extent in patients with mild OSA. The slight worsening of respiratory parameters over time was not associated with any relevant changes in sleepiness and symptoms. Moderate or severe OSA at baseline, treatment success at 3–6 months, and no previous continuous positive airway pressure use were significant independent predictors of 5-year treatment success on multivariate analysis. No new safety signals emerged during long-term follow-up. The proportion of patients using their MAD for ≥4 h/night on ≥4 days/wk was 93.3%; 91.3% of patients reported device use of ≥6 h/night at 5 years. At 5-year follow-up, 96.5% of patients reported that they wanted to continue MAD therapy. CONCLUSIONS: Long-term MAD therapy remained effective after 5 years in >50% of patients, with good levels of patient satisfaction and adherence. CITATION: Vecchierini MF, Attali V, Collet JM, et al. Mandibular advancement device use in obstructive sleep apnea: ORCADES study 5-year follow-up data. J Clin Sleep Med. ... Text narval narval PubMed Central (PMC) Journal of Clinical Sleep Medicine 17 8 1695 1705 |
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Scientific Investigations Vecchierini, Marie-Françoise Attali, Valérie Collet, Jean-Marc d'Ortho, Marie-Pia Goutorbe, Frederic Kerbrat, Jean-Baptiste Leger, Damien Lavergne, Florent Monaca, Christelle Monteyrol, Pierre-Jean Mullens, Eric Pigearias, Bernard Martin, Francis Khemliche, Hauria Lerousseau, Lionel Meurice, Jean-Claude Mandibular advancement device use in obstructive sleep apnea: ORCADES study 5-year follow-up data |
topic_facet |
Scientific Investigations |
description |
STUDY OBJECTIVES: Mandibular advancement devices (MADs) are an alternative to continuous positive airway pressure for the management of obstructive sleep apnea (OSA). The ORthèse d’avanCée mAndibulaire dans le traitement en DEuxième intention du SAHOS sévère (ORCADES) study is investigating the long-term effectiveness of MAD therapy in patients with OSA who refused or were intolerant of continuous positive airway pressure. Five-year follow-up data are presented. METHODS: Data were available in 172 of 331 patients treated with a custom-made computer-aided design/computer-aided manufacturing biblock MAD (Narval CC; ResMed, Saint-Priest, France). The primary end point was treatment success (≥50% decrease in apnea-hypopnea index from baseline). RESULTS: Five-year treatment success rates were 52% overall and 25%, 52%, and 63%, respectively, in patients with mild, moderate, or severe OSA. This reflects a decline over time vs 3–6 months (79% overall) and 2 years (68%). Rates declined in all patient subgroups but to the greatest extent in patients with mild OSA. The slight worsening of respiratory parameters over time was not associated with any relevant changes in sleepiness and symptoms. Moderate or severe OSA at baseline, treatment success at 3–6 months, and no previous continuous positive airway pressure use were significant independent predictors of 5-year treatment success on multivariate analysis. No new safety signals emerged during long-term follow-up. The proportion of patients using their MAD for ≥4 h/night on ≥4 days/wk was 93.3%; 91.3% of patients reported device use of ≥6 h/night at 5 years. At 5-year follow-up, 96.5% of patients reported that they wanted to continue MAD therapy. CONCLUSIONS: Long-term MAD therapy remained effective after 5 years in >50% of patients, with good levels of patient satisfaction and adherence. CITATION: Vecchierini MF, Attali V, Collet JM, et al. Mandibular advancement device use in obstructive sleep apnea: ORCADES study 5-year follow-up data. J Clin Sleep Med. ... |
format |
Text |
author |
Vecchierini, Marie-Françoise Attali, Valérie Collet, Jean-Marc d'Ortho, Marie-Pia Goutorbe, Frederic Kerbrat, Jean-Baptiste Leger, Damien Lavergne, Florent Monaca, Christelle Monteyrol, Pierre-Jean Mullens, Eric Pigearias, Bernard Martin, Francis Khemliche, Hauria Lerousseau, Lionel Meurice, Jean-Claude |
author_facet |
Vecchierini, Marie-Françoise Attali, Valérie Collet, Jean-Marc d'Ortho, Marie-Pia Goutorbe, Frederic Kerbrat, Jean-Baptiste Leger, Damien Lavergne, Florent Monaca, Christelle Monteyrol, Pierre-Jean Mullens, Eric Pigearias, Bernard Martin, Francis Khemliche, Hauria Lerousseau, Lionel Meurice, Jean-Claude |
author_sort |
Vecchierini, Marie-Françoise |
title |
Mandibular advancement device use in obstructive sleep apnea: ORCADES study 5-year follow-up data |
title_short |
Mandibular advancement device use in obstructive sleep apnea: ORCADES study 5-year follow-up data |
title_full |
Mandibular advancement device use in obstructive sleep apnea: ORCADES study 5-year follow-up data |
title_fullStr |
Mandibular advancement device use in obstructive sleep apnea: ORCADES study 5-year follow-up data |
title_full_unstemmed |
Mandibular advancement device use in obstructive sleep apnea: ORCADES study 5-year follow-up data |
title_sort |
mandibular advancement device use in obstructive sleep apnea: orcades study 5-year follow-up data |
publisher |
American Academy of Sleep Medicine |
publishDate |
2021 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8656912/ http://www.ncbi.nlm.nih.gov/pubmed/34165074 https://doi.org/10.5664/jcsm.9308 |
genre |
narval narval |
genre_facet |
narval narval |
op_source |
J Clin Sleep Med |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8656912/ http://www.ncbi.nlm.nih.gov/pubmed/34165074 http://dx.doi.org/10.5664/jcsm.9308 |
op_rights |
© 2021 American Academy of Sleep Medicine |
op_doi |
https://doi.org/10.5664/jcsm.9308 |
container_title |
Journal of Clinical Sleep Medicine |
container_volume |
17 |
container_issue |
8 |
container_start_page |
1695 |
op_container_end_page |
1705 |
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1766244605378953216 |