Effectiveness of a fully digital mandibular advancement appliance compared with CPAP in the treatment of obstructive sleep apnea.
Taciana Morum, Daniela Sampaio, Julia Badia Hecksher et al.
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In 30 seconds
This crossover clinical study compared a fully digital mandibular advancement appliance (MAA) with CPAP in 20 adults with obstructive sleep apnea (OSA), confirmed by polysomnography and non-adherent to CPAP. Participants underwent home sleep testing without treatment and with each therapy. Median oxygen desaturation index (ODI) fell from 13.55 events/hour untreated to 6.05 with MAA and 5.30 with CPAP. The treatments did not differ significantly on several measured outcomes, including ODI, snoring, hypoxic burden, and heart rate; oxygen saturation favored CPAP, with a small difference.
Key findings
- Median ODI decreased from 13.55 events/hour untreated to 6.05 with MAA and 5.30 with CPAP.
- No significant MAA–CPAP differences were found for ΔODI (p = 0.401), snoring (p = 0.103), hypoxic burden (p = 0.165), or heart rate (p = 0.824).
- Oxygen saturation differed significantly between treatments (p = 0.003), favoring CPAP; the authors described the difference as small.
Why it matters
The findings suggest that a digitally produced MAA can improve oxygen desaturation and snoring in adults with OSA who are not adherent to CPAP. The comparison also highlights that treatment effects may vary by outcome: oxygen saturation favored CPAP, while several other measures showed no significant difference. This may inform consideration of alternatives when CPAP adherence is a challenge.
What to keep in mind
The study included only 20 adults, and participants were non-adherent to CPAP with AHI < 50 events/hour, limiting how broadly the findings can be applied.