Abstract
INTRODUCTION: ORCADES, a national prospective multicentre cohort study is evaluating the long-term benefits of a custom-made MRD in OSA patients noncompliant with Continuous Positive Airway Pressure (CPAP).
AIMS AND METHODS: 379 OSA pts fitted with a custom-made titratable MRD (ResMed, Narval™) are evaluated over 5 years for evolution of respiratory and sleep data, symptoms, quality of life, compliance and side effects. Interim data of systematic polygraphy/polysomnography and dental sleep assessment at 2 years minimum FU are presented here.
RESULTS: 73% of patients treated with MRD were kept in the study at 2 years FU. 16% stopped prematurely MRD for either side effect (8%) or lack of efficacy (8%), and 11% withdrew the study or returned to CPAP therapy. AHI decreased globally under MRD therapy from 28±14/h (median [Q1; Q3]: 26 [18; 37]) at baseline to 12±12/h (median [Q1; Q3]: 8 [4; 16]) at 2-year FU. An AHI<10 was achieved in 80%, 69% and 35% of patients with mild, moderate and severe OSA, respectively. Mean Epworth score was reduced from 12±5 to 7±4.
In severe OSA patients (AHI>30), AHI was reduced from 41±11 (median [Q1; Q3]: 37 [32; 47]) at baseline to 18±15 (median [Q1; Q3]: 14 [8; 23]) at 2-year FU. Moreover, a decrease in baseline AHI by ≥50% + post-treatment AHI<20 was reached in 66% of severe OSA.
Compared to previous 3 month-FU evaluation, MRD efficacy and compliance (6.7h/night, 6.6 days/week) were kept at similar level in the 3 OSA severity groups.
CONCLUSION: Effectiveness of custom-made Narval MRD in noncompliant CPAP patients is satisfactorily maintained at long-term FU irrespective of initial OSA severity.
- Copyright ©the authors 2016