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J Dent Res 86(12):1181-1186, 2007
© 2007 International and American Associations for Dental Research


RESEARCH REPORT
Clinical

Predictors of Obstructive Sleep Apnea-Hypopnea Treatment Outcome

A. Hoekema1,*, M.H.J. Doff1, L.G.M. de Bont1, J.H. van der Hoeven2, P.J. Wijkstra3, H.R. Pasma4, and B. Stegenga1

1 Department of Oral and Maxillofacial Surgery,
2 Department of Clinical Neurophysiology, and
3 Department of Home Mechanical Ventilation, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands; and
4 Department of Pulmonary Diseases, Medical Center Leeuwarden, Leeuwarden, The Netherlands

* corresponding author, a.hoekema{at}kchir.umcg.nl

Oral appliance therapy is an alternative to continuous positive airway pressure (CPAP) for treating the obstructive sleep apnea-hypopnea syndrome. However, the ability to pre-select suitable candidates for either treatment is limited. The aim of this study was to assess the value of relevant variables that can predict the outcome of oral appliance and CPAP therapy. Fifty-one patients treated with oral appliance therapy and 52 patients treated with CPAP were included. Relevant clinical, polysomnographic, and cephalometric variables were determined at baseline. The predictive value of variables for treatment outcome was evaluated in univariate and multivariate analyses. The outcome of oral appliance therapy was favorable, especially in less obese patients with milder sleep apnea and with certain craniofacial characteristics (mandibular retrognathism in particular). Neither univariate nor multivariate analyses yielded variables that reliably predicted the outcome of CPAP. We conclude that the variables found in this study are valuable for pre-selecting suitable candidates for oral-appliance therapy.

KEY WORDS: sleep apnea syndromes • orthodontic appliances • positive-pressure ventilation • treatment outcome • predictors







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