The primary OSA therapies—CPAP and oral appliances—require continuous use during sleep. Studies highlight that oral appliances are often the preferred option. Over the years, significant advancements in this treatment have led to several positive outcomes, such as a reduction in arterial blood pressure and improvements in energy levels, attention, and memory, among others.
This article analyzes the adherence of 58 patients diagnosed with moderate to severe OSA. The authors measured the number of hours of use over 60 days using a thermal sensor in an oral appliance.
More than 80% of patients demonstrated positive adherence. The leading cause of withdrawal in the remaining group was a lack of perceived improvement. Participants who maintained good adherence during the first 20 days continued to use the device consistently for 60 days.
What strategies can optimize higher adherence?
Strategies to Optimize Adherence to OSA Treatment Using Oral Appliances
The process begins with an individualized analysis of each case. The patient’s profile, specific challenges, and the severity of the condition are key factors in determining whether an oral appliance is appropriate.
However, which model should we choose? A sleep dentist has access to a wide range of devices, each designed to meet the specific needs of different patient groups.
Addressing the patient’s difficulties is crucial. During the first few days, follow-up via WhatsApp is recommended to help manage potential discomfort, such as poor appliance retention, muscle soreness, and difficulty falling asleep. This type of support can make a significant difference. Additionally, evaluating objective results—such as oxygen saturation, hypoxic burden, and snoring—using a validated Type IV polysomnography (high-resolution oximetry) is essential. In some cases, switching models or incorporating another therapy method can be an effective strategy. Furthermore, implementing sleep hygiene measures is always highly recommended.
Objective and subjective monitoring allows for necessary adjustments to treatment.
Obstructive sleep apnea is a chronic and progressive disease that requires long-term follow-up. In some cases, combining or modifying therapies may be necessary to achieve optimal results.
By Dr. Walter Silva Júnior
Sleep dentist certified by the American Board of Dental Sleep Medicine (ABDSM).
Ph.D. in Sleep Medicine at the Hospital for Rehabilitation of Craniofacial Anomalies/University of São Paulo – Bauru, São Paulo.
Website: http://www.institutowaltersilva.com.br/
Instagram: @walter_silva_odontologiadosono
REFERENCE: Treatment usage patterns of oral appliances for obstructive sleep apnea over the first 60 days: a cluster analysis.
Sutherland K, Almeida FR, Kim T, et al.
J Clin Sleep Med. 2021;17(9):1785–1792
The Biologix Sleep Test®
Diagnosing obstructive sleep apnea is both simple and essential. The Biologix Sleep Test® is a remote polysomnography that monitors oxygen saturation, heart rate, actigraphy, and snoring using a smartphone microphone.
Designed for at-home use, this test offers a simple yet effective method for healthcare practitioners to diagnose and monitor sleep apnea.
At bedtime, the patient only needs to place the sensor on their finger and start the test in the Biologix app. Upon waking up the next morning, after finishing the test, the result will be available at the exam portal in a matter of seconds.
