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Article

Evaluation of Respiratory Resistance as a Predictor for Oral Appliance Treatment Response in Obstructive Sleep Apnea: A Pilot Study

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Dental Anesthesiology and Orofacial Pain Management, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
2
Dental Clinic for Sleep Disorders (Apnea and Snoring), Oral and Maxillofacial Rehabilitation, Dental Hospital, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
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Removable Partial Prosthodontics, Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
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Department of Respiratory Physiology and Sleep Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
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Department of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
*
Author to whom correspondence should be addressed.
Academic Editors: Yuksel Peker and Nathaniel Watson
J. Clin. Med. 2021, 10(6), 1255; https://doi.org/10.3390/jcm10061255
Received: 13 January 2021 / Revised: 6 March 2021 / Accepted: 16 March 2021 / Published: 18 March 2021
(This article belongs to the Special Issue Current Perspectives on the Treatment of Obstructive Sleep Apnea)
The aim of this study was to determine the utility of respiratory resistance as a predictor of oral appliance (OA) response in obstructive sleep apnea (OSA). Twenty-seven patients with OSA (mean respiratory event index (REI): 17.5 ± 6.5 events/h) were recruited. At baseline, the respiratory resistance (R20) was measured by impulse oscillometry (IOS) with a fitted nasal mask in the supine position, and cephalometric radiographs were obtained to analyze the pharyngeal airway space (SPAS: superior posterior airway space, MAS: middle airway space, IAS: inferior airway space). The R20 and radiographs after the OA treatment were evaluated, and the changes from the baseline were analyzed. A sleep test with OA was carried out using a portable device. The subjects were divided into Responders and Non-responders based on an REI improvement ≥ 50% from the baseline, or REI < 5 after treatment, and the R20 reduction rate between the two groups were compared. The subjects comprised 20 responders and 7 non-responders. The R20 reduction rate with OA in responders was significantly greater than it was in non-responders (14.4 ± 7.9 % versus 2.4 ± 9.8 %, p < 0.05). In responders, SPAS, MAS, and IAS were significantly widened and R20 was significantly decreased with OA (p < 0.05). There was no significant difference in non-responders (p > 0.05). A logistic multiple regression analysis showed that the R20 reduction rate was predictive for OA treatment responses (2% incremental odds ratio (OR), 24.5; 95% CI, 21.5–28.0; p = 0.018). This pilot study confirmed that respiratory resistance may have significant clinical utility in predicting OA treatment responses. View Full-Text
Keywords: obstructive sleep apnea; oral appliance; predictor; respiratory resistance; impulse oscillometry obstructive sleep apnea; oral appliance; predictor; respiratory resistance; impulse oscillometry
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MDPI and ACS Style

Ishiyama, H.; Hideshima, M.; Inukai, S.; Tamaoka, M.; Nishiyama, A.; Miyazaki, Y. Evaluation of Respiratory Resistance as a Predictor for Oral Appliance Treatment Response in Obstructive Sleep Apnea: A Pilot Study. J. Clin. Med. 2021, 10, 1255. https://doi.org/10.3390/jcm10061255

AMA Style

Ishiyama H, Hideshima M, Inukai S, Tamaoka M, Nishiyama A, Miyazaki Y. Evaluation of Respiratory Resistance as a Predictor for Oral Appliance Treatment Response in Obstructive Sleep Apnea: A Pilot Study. Journal of Clinical Medicine. 2021; 10(6):1255. https://doi.org/10.3390/jcm10061255

Chicago/Turabian Style

Ishiyama, Hiroyuki, Masayuki Hideshima, Shusuke Inukai, Meiyo Tamaoka, Akira Nishiyama, and Yasunari Miyazaki. 2021. "Evaluation of Respiratory Resistance as a Predictor for Oral Appliance Treatment Response in Obstructive Sleep Apnea: A Pilot Study" Journal of Clinical Medicine 10, no. 6: 1255. https://doi.org/10.3390/jcm10061255

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