Chest
Clinical InvestigationsSleep4-Year Follow-up of Treatment With Dental Appliance or Uvulopalatopharyngoplasty in Patients With Obstructive Sleep Apnea: A Randomized Study
Section snippets
Definitions
Apnea was defined as cessation of respiratory air flow for a minimum of 10 s as measured by a thermistor. Hypopnea was considered to be present when there was a 50% reduction of the air-flow signal recorded by a thermistor combined with a decrease in hemoglobin oxygen saturation of at least 4%. The apnea index (AI) was defined as the average number of apneas per hour of sleep, and the apnea/hypopnea index (AHI) was defined as the average number of apneas plus hypopneas per hour of sleep. The
Results
The mean length of follow-up time measured from the time of randomization was 4.1 years (range, 3.8 to 5.4 years). The baseline values, previously published,23 did not differ significantly between the groups in any of the recorded somnographic variables or in age or BMI.
BMI did not differ between the dental-appliance and UPPP groups at the 1-year and 4-year follow-ups (1-year follow-up, p = 0.223; 4-year follow-up, p = 0.278). There was a significant change in BMI during the course of the study
Discussion
There is general agreement that patients with OSA should have treatment to reduce the frequency of apneas and hypopneas and thus alleviate the subjective disorders. There are also reasons to believe that effective treatment will have positive influence on the prognosis.10, 11
The number of reports of long-term effects of UPPP (after > 1 year) on somnographic variables is limited.12, 13, 14 In these studies, the effects of UPPP were found to be reduced over time. Jansson et al14 found a decrease
Conclusion
In this 4-year follow-up study, the somnographic variables showed a significantly higher success and normalization rate in the dental-appliance group than in the group treated with UPPP. The superior effectiveness of the dental appliance compared to UPPP is partly invalidated by the compliance of 62% in the dental-appliance group. The appliance had few adverse effects on the stomatognathic system; in view of the few adjustments and repairs that were required over time, its construction seems
ACKNOWLEDGMENT
The authors thank Tore Bremer, Kerstin Juhlin, and Laila Olsson for help with the patients in this study.
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