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. 2025 Jan:125:27-30.
doi: 10.1016/j.sleep.2024.11.027. Epub 2024 Nov 16.

Three-dimensional mean disease alleviation (3D-MDA): The next step in measuring sleep apnea treatment effectiveness

Thomas M Kaffenberger  1 , Ryan J Soose  2 , Patrick J Strollo  3 , Olivier M Vanderveken  4
Affiliations
Free article

Three-dimensional mean disease alleviation (3D-MDA): The next step in measuring sleep apnea treatment effectiveness

Thomas M Kaffenberger et al. Sleep Med. 2025 Jan.
Free article

Abstract

Mean disease alleviation measures the effectiveness of Obstructive Sleep Apnea (OSA) treatments. It combines a patient's adherence to treatment normalized to their total sleep time and the treatment's efficacy as determined by the change in the apnea-hypopnea index. This metric fails to capture the patient's OSA-related symptoms, which are a key component and, in some cases, the primary component, of determining response to treatment. We propose an enhanced metric called three-dimensional mean disease alleviation (3D-MDA), which incorporates the symptom response to better reflect the true treatment impact. RESULTS: The proposed 3D-MDA metric aims to provide a more comprehensive assessment of OSA treatment effectiveness by integrating the subjective impact, therapy adherence, and objective efficacy. Further, 3D-MDA is adaptable over time as the optimal metrics for these categories continue to evolve.

Keywords: CPAP; Mandibular advancement devices; Mean disease alleviation; Obstructive sleep apnea; Sleep surgery.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Thomas Kaffenberger reports a relationship with Inspire Medical Systems Inc that includes: consulting or advisory. Thomas Kaffenberger reports a relationship with Nyxoah SA that includes: consulting or advisory. Thomas Kaffenberger reports a relationship with Cryosa medical that includes: funding grants. Ryan Soose reports a relationship with Cryosa Medical that includes: consulting or advisory. Ryan Soose reports a relationship with XII Medical that includes: consulting or advisory. Ryan Soose reports a relationship with Inspire Medical Systems Inc that includes: consulting or advisory and funding grants. Patrick Strollo reports a relationship with Inspire Medical Systems Inc that includes: consulting or advisory. Patrick Strollo reports a relationship with XII Medical that includes: consulting or advisory. Patrick Strollo reports a relationship with Restora that includes: consulting or advisory. Patrick Strollo reports a relationship with Cryosa Medical that includes: consulting or advisory. Patrick Strollo reports a relationship with Somnomed that includes: consulting or advisory. Patrick Strollo reports a relationship with ZOLL Medical Corporation that includes: consulting or advisory. Patrick Strollo reports a relationship with Itamar-Medical Inc. That includes: consulting or advisory. Patrick Strollo reports a relationship with ResMed that includes: consulting or advisory. Patrick Strollo reports a relationship with Emmi systems that includes: consulting or advisory. Patrick Strollo reports a relationship with WhisperSom that includes: consulting or advisory. Patrick Strollo reports a relationship with Apnimed Inc that includes: consulting or advisory. Patrick Strollo reports a relationship with Philips Respironics Ltd that includes: consulting or advisory. Patrick Strollo reports a relationship with Belluscura LLC that includes: board membership. Olivier Vanderveken reports a relationship with Cochlear Ltd that includes: funding grants. Olivier Vanderveken reports a relationship with MED-EL Electromedical Equipment that includes: funding grants. Olivier Vanderveken reports a relationship with Inspire Medical Systems Inc that includes: consulting or advisory and funding grants. Olivier Vanderveken reports a relationship with Nyxoah SA that includes: funding grants. Olivier Vanderveken reports a relationship with Philips that includes: funding grants. Olivier Vanderveken reports a relationship with ProSomnus that includes: funding grants. Olivier Vanderveken reports a relationship with SomnoMed that includes: consulting or advisory and funding grants. Olivier Vanderveken reports a relationship with GSK that includes: consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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