Abstract | BACKGROUND: It has been recognized that mandibular advancement splint (MAS) treatment is effective in some, but not all, patients with obstructive sleep apnea (OSA). Hence there is a need for a simple and reliable clinical tool to assist in the differentiation of treatment responses. We hypothesized that abnormalities of flow-volume curves, together with other clinical variables, may have clinical utility in the prediction of MAS treatment outcome. METHODS: Fifty-four patients with known OSA underwent MAS treatment. Expiratory and inspiratory flow-volume curves were measured in the erect and supine positions to derive midinspiratory flow (MIF(50)) and the ratio of expiratory to inspiratory flow at 50% of vital capacity (MEF(50):MIF(50)). Multivariable logistic regression was performed to identify additional significant clinical variables in the prediction of treatment outcome. RESULTS: The mean (+/- SD) apnea-hypopnea index (AHI) in 35 responders was significantly reduced from 28.9 +/- 13.7 to 6.7 +/- 5.8/hour (p<0.001). In 19 nonresponders there was no significant change in AHI. MIF(50) was lower (6.04 +/- 1.80 vs. 6.88 +/- 1.08 L/second; p=0.035) and the MEF(50):MIF(50) ratio was higher (0.82 +/- 0.23 vs. 0.61 +/- 0.15; p=0.001) in responders than nonresponders. Logistic regression analysis revealed that the MEF(50):MIF(50) ratio was the most important predictive factor for MAS treatment outcome, but that body mass index, age, and baseline AHI were also contributory. CONCLUSIONS: These data suggest that flow-volume curves, in combination with other factors such as body mass index, age, and baseline AHI, may have a useful clinical role in the prediction of treatment outcome with MAS.
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Authors | Biao Zeng, Andrew T Ng, M Ali Darendeliler, Peter Petocz, Peter A Cistulli |
Journal | American journal of respiratory and critical care medicine
(Am J Respir Crit Care Med)
Vol. 175
Issue 7
Pg. 726-30
(Apr 01 2007)
ISSN: 1073-449X [Print] United States |
PMID | 17218619
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Adult
- Female
- Humans
- Male
- Mandibular Advancement
(instrumentation)
- Middle Aged
- Orthodontic Appliances, Removable
- Predictive Value of Tests
- Pulmonary Ventilation
(physiology)
- ROC Curve
- Sleep Apnea, Obstructive
(physiopathology, therapy)
- Spirometry
- Total Lung Capacity
(physiology)
- Treatment Outcome
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