As oral appliance therapy continues to gain respect across the health care continuum, predictors of treatment outcomes are emerging. Small and detailed physiological studies that look at OSA endotypic traits (pharyngeal collapsibility and loop gain) can help determine greater oral appliance efficacy.
PubMed reports: In 93 patients (baseline apnea-hypopnea index [AHI] ≥20 events/hr), researchers examined whether polysomnography-estimated OSA traits (pharyngeal: collapsibility and muscle compensation; non-pharyngeal: loop gain, arousal threshold and ventilatory response to arousal) were associated with oral appliance efficacy (percent reduction in AHI from baseline) and could predict responses to treatment. Multivariable regression (with interactions) defined endotype-based subgroups of “predicted” responders and non-responders (based on 50% reduction in AHI). Treatment efficacy was compared between the predicted subgroups (with cross-validation).
Greater oral appliance efficacy “was associated with favorable non-pharyngeal traits (lower loop gain, higher arousal threshold and lower response to arousal), moderate (non-mild, non-severe) pharyngeal collapsibility and weaker muscle compensation (overall R2=0.30, adjusted R2=0.19, p=0.003).”
See the study abstract for more information