Abstract
Background/aim: Oral appliance therapy (OAT) often lacks the technology to assess objective daily compliance. The aim of this study was to compare objective compliance between OAT and continuous positive airway pressure (CPAP). Furthermore, objective and subjective compliance with OAT, and the agreement of two compliance chips on daily use of OAT was assessed.
Methods: Compliance was monitored in patients with moderate obstructive sleep apnea (apnea-hypopnea index (AHI) 15-30) as part of a randomized controlled trial (RCT). Objective compliance with CPAP was recorded via a built-in SD-card. Objective compliance with OAT (SomnoDent) was assessed using the TheraMon® chip (Orthosmart BV). A second chip (DentiTrac® Braebon Medical Corporation) was used simultaneously. Agreement on daily use between both chips was calculated using a Bland and Altman plot. Subjective compliance was assessed using a questionnaire.
Results: Objective daily use (first 90 days) was available for 46 patients (n=16 OAT, mean AHI 20.7; n=30 CPAP, mean AHI 21.3). OAT and CPAP were used for the same percentage of nights (87% and 82% respectively), but usage duration during the night was higher with OAT (median [IQR] 7.8 [6.3-8.2]) than with CPAP (median [IQR] 6.8 [5.1-7.4], p=0.01). There was no difference between median [interquartile range (IQR)] objective (7.9 [6.5-8.2]) and subjective (7.5 [7.0-8.0]) daily use with OAT (p=0.51). Agreement of both chips was high (mean differences = -0.11 to 0.13 hours/night).
Conclusion: Objective and subjective compliance with OAT were similar. When therapy was used, compliance with OAT was significantly higher than with CPAP. This might influence long-term effects of OAT and CPAP.
- Copyright ©the authors 2017
