Evaluation of Oral Appliance Therapy in Patients with Obstructive Sleep Apnea Syndrome: A Comparative Analysis by Age, Severity, and BMI

Abstract

Background Obstructive sleep apnea syndrome is a common disorder characterized by repeated upper airway obstruction during sleep. Oral appliance therapy is a noninvasive treatment option commonly recommended for patients who are intolerant to continuous positive airway pressure. This study aimed to evaluate the treatment outcomes of oral appliance therapy in patients with obstructive sleep apnea syndrome and to examine the relationship between therapeutic effectiveness and patient characteristics, including age, disease severity, and body mass index.

Methods A total of 42 patients diagnosed with obstructive sleep apnea syndrome and treated with oral appliance therapy were retrospectively analyzed. The treatment effect was assessed using the apnea–hypopnea index measured before and after therapy (by polysomnography or portable monitoring). Effective treatment was defined as a post-treatment apnea–hypopnea index of <15 events per hour and a ≥ 50% reduction from baseline.

Results The mean apnea–hypopnea index decreased significantly from 27.6 ± 15.7 to 10.3 ± 8.7 events per hour following oral appliance therapy, with a mean improvement in AHI of 59.6%. Effectiveness was achieved in 66.7% of patients. A significant overall improvement was observed. Reductions in the apnea–hypopnea index were seen across age, severity, and body mass index (BMI) strata. However, only three patients had BMI ≥30 kg/m²; hence, BMI-stratified findings for this subgroup are descriptive and no inferential testing was conducted.

Conclusion Oral appliance therapy was effective in reducing the apnea–hypopnea index in a broad range of patients, including those traditionally considered less responsive because of advanced age, obesity, or severe disease. These findings suggest a potential role for oral appliance therapy as an alternative to continuous positive airway pressure treatment within the examined strata (age, severity, and BMI), particularly when continuous positive airway pressure therapy is not feasible. Larger prospective studies are warranted.