Late Breaking Abstract - Efficacy and tolerability of a custom-made mandibular repositioning device (MRD) for the treatment of obstructive sleep apnea (OSA): ORCADES study 5-year follow-up data

Orcades is the largest long-term prospective multicentre cohort study evaluating mild-to-severe OSA patients (pts) who refused or were not compliant with CPAP therapy, treated with CAD/CAM (Computer-Aided Design/Computer-Aided Manufacturing) MRD.Methods: 332 OSA pts fitted with a ResMed MRD (Narval CC™) are evaluated over 5 years. Respiratory and sleep data, symptoms, quality of life, compliance & side effects at 5-year follow-up (FU) are presented.Results: 52% of pts treated with MRD were still in the study after 5-year FU. 8.7% stopped prematurely MRD for lack of efficacy, 11.4% for side effects, 6.6% returned to CPAP therapy. Median AHI was reduced significantly (-11.1/h, p<0.0001) from 26.4/h at baseline to 11.1/h at 5-year FU. In severe OSA pts, median AHI was reduced significantly (-22.3/h, p<0.0001) from 39/h to 14.8/h. Therapy success at 5-year FU (%of pts with an AHI decrease≥50%) was 52% irrespective of initial OSA severity, 62% in severe OSA ptsAn AHI<10 was achieved in 52% of moderate OSA pts. In severe OSA pts, 28% achieved an AHI<10, 51% achieved an AHI<15 were properly treated. Mean ESS was reduced from 11 to 7 (p<0.0001). Compared to baseline & short-term FU evaluation, ESS, symptoms and Quality of life improved overtime & compliance was stable (6.7h/night, 6.6 days/week). In univariate analysis, therapy failure is associated with weight gain (2±5 kg), success with slight weight decrease (-1±8 kg), p=0.045At...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and control of breathing Source Type: research