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. 2022 Apr;31(2):e13462.
doi: 10.1111/jsr.13462. Epub 2021 Sep 6.

Partner perceptions are associated with objective sensor-measured adherence to oral appliance therapy in obstructive sleep apnea

Kjersti Gjerde  1   2 , Sverre Lehmann  2   3   4 , Bjørn Bjorvatn  2   4   5 , Morten Berge  1   2 , Frode Thuen  6 , Thomas Berge  2 , Anders Johansson  1   2
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Partner perceptions are associated with objective sensor-measured adherence to oral appliance therapy in obstructive sleep apnea

Kjersti Gjerde et al. J Sleep Res. 2022 Apr.

Abstract

The aims of the present prospective clinical study were to determine objective, sensor-measured adherence to a mandibular advancement device (MAD) in patients with obstructive sleep apnea (OSA) and to identify partner-specific adherence-related factors. A total of 77 eligible participants with mild, moderate, or severe OSA and who were non-adherent to continuous positive airway pressure (mean age 56.2 years) participated in the study (32.5% women). The mean (range) observation time between MAD delivery and final follow-up was 8.3 (3.4-16.5) months. The mean apnea-hypopnea index (AHI) was 26.6 events/hr at baseline and 12.5 events/hr at the 8-month follow-up (both p < 0.001). The mean sensor-measured adherence at the 8-month follow-up was 60.1% for ≥4 hr/night of appliance use for ≥5 days/week. Average usage was 6.4 hr/night, when worn. The mean reduction in the AHI was significantly greater in the "good adherence" (Δ 17.4) than the "poor adherence" group (Δ11.0; p < 0.05). From the partner's perspective, the appliance had a positive effect on sharing a bedroom in the good- (55%) compared to the poor-adherence group (25%; p < 0.05) and on their relationship (51.7% versus 17.9%, respectively; p < 0.05). Regression analyses identified the partner's snoring and apneas to be the most significant factor predicting good adherence to MAD (odds ratio 4.4, 95% confidence interval 1.4-14.0). In conclusion, social factors, like partner perceptions, were positively associated with adherence, which indicate that partner's attitudes and support may be a resource that can be utilised to improve adherence in oral appliance treatment of OSA.

Keywords: compliance; longitudinal; psychosocial factors; sleep apnea syndrome; titration.

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