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Sex differences in mandibular repositioning device therapy effectiveness in patients with obstructive sleep apnea syndrome. 2019
Marie-Françoise Vecchierini, and
Valérie Attali, and
Jean-Marc Collet, and
Marie-Pia d'Ortho, and
Frederic Goutorbe, and
Jean-Baptiste Kerbrat, and
Damien Leger, and
Florent Lavergne, and
Christelle Monaca, and
Pierre-Jean Monteyrol, and
Laurent Morin, and
Eric Mullens, and
Bernard Pigearias, and
Francis Martin, and
Hauria Khemliche, and
Lionel Lerousseau, and
Jean-Claude Meurice, and
, and
Darius Abedipour, and
Aurélie Allard-Redon, and
Alexandre Aranda, and
Valérie Attali, and
Frédérique Bavozet, and
Martine Becu, and
Wally Beruben, and
Jerome Bessard, and
Isabelle Bonafe, and
Mohammed Boukhana, and
Bruno Chabrol, and
Gérard Chatte, and
Chauvel Lebret, and
Jean-Marc Collet, and
Olivier Coste, and
Nathalie Dumont, and
Sophie Durand-Amat, and
Marie-Pia D'ortho, and
Jean Marc Elbaum, and
Olivier Gallet De Santerre, and
Frédéric Goutorbes, and
Thierry Grandjean, and
Wilma Guyot, and
Doniphan Hammer, and
Carmen Havasi, and
Pascal Huet, and
Jean Baptiste Kerbrat, and
Hauria Khemliche, and
Christian Koltes, and
Damien Leger, and
Laurent Lacassagne, and
Xavier Laur, and
Lionel Lerousseau, and
Olivier Liard, and
Christophe Loisel, and
Matthieu Longuet, and
Anne Mallart, and
Francis Martin, and
Frédéric Merle Beral, and
Jean Claude Meurice, and
Zoubida Mokhtari, and
Christelle Monaca, and
Pierre Jean Monteyrol, and
Jean-François Muir, and
Eric Mullens, and
Dominique Muller, and
Charles Paoli, and
François Xavier Petit, and
Bernard Pigearias, and
Marc Pradines, and
Arnauld Prigent, and
Gil Putterman, and
Marc Rey, and
Mickael Samama, and
Renaud Tamisier, and
Michel Tiberge, and
Cyrille Tison, and
Fabienne Tordjman, and
Bernard Triolet, and
Christian Vacher, and
Marie-Françoise Vecchierini, and
Alain Verain
AP-HP, Centre du Sommeil et de la Vigilance, Hôpital Hôtel Dieu, Paris, France.
OBJECTIVE Mandibular repositioning devices (MRDs) are an effective treatment option for obstructive sleep apnea syndrome (OSAS), particularly in patients who refuse or cannot tolerate continuous positive airway pressure (CPAP). However, sex differences in the response to therapy and predictors of response are not clearly defined. This analysis of data from the long-term prospective ORCADES trial compared MRD efficacy in men and women with OSAS. METHODS The ORCADES study included patients with newly diagnosed mild-to-moderate or severe OSAS who refused or were non-compliant with CPAP. MRD therapy was titrated over 3-6 months. The primary endpoint was treatment success (≥ 50% decrease in apnea-hypopnea index (AHI)). Complete response was defined using a range of AHI cut-off values (< 5/h, < 10/h, < 15/h). RESULTS Overall treatment success rates were 89% in women and 76% in men (p = 0.019); corresponding rates in those with severe OSAS (AHI > 30/h) were 100% and 68% (p = 0.0015). In women vs. men, overall complete response rates at AHI cut-off values of < 5/h, <10/h, and < 15/h were 49 vs. 34% (p = 0.0052), 78 vs. 62% (p = 0.016), and 92 vs. 76% (p = 0.0032). On multivariate analysis, significant predictors of MRD treatment success were overbite and baseline apnea index in men, and neck circumference and no previous CPAP therapy in women. There were sex differences in the occurrence of side effects. Temporomandibular joint pain was the most common reason for stopping MRD therapy. CONCLUSIONS MRD therapy was effective in women with OSA of any severity, with significantly higher response rates compared with men especially in severe OSAS. BACKGROUND www.clinicaltrials.gov (NCT01326143).
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Jerome Bessard, and
Isabelle Bonafe, and
Mohammed Boukhana, and
Bruno Chabrol, and
Gérard Chatte, and
Chauvel Lebret, and
Jean-Marc Collet, and
Olivier Coste, and
Nathalie Dumont, and
Sophie Durand-Amat, and
Marie-Pia D'ortho, and
Jean Marc Elbaum, and
Olivier Gallet De Santerre, and
Frédéric Goutorbes, and
Thierry Grandjean, and
Wilma Guyot, and
Doniphan Hammer, and
Carmen Havasi, and
Pascal Huet, and
Jean Baptiste Kerbrat, and
Hauria Khemliche, and
Christian Koltes, and
Damien Leger, and
Laurent Lacassagne, and
Xavier Laur, and
Lionel Lerousseau, and
Olivier Liard, and
Christophe Loisel, and
Matthieu Longuet, and
Anne Mallart, and
Francis Martin, and
Frédéric Merle Beral, and
Jean Claude Meurice, and
Zoubida Mokhtari, and
Christelle Monaca, and
Pierre Jean Monteyrol, and
Jean-François Muir, and
Eric Mullens, and
Dominique Muller, and
Charles Paoli, and
François Xavier Petit, and
Bernard Pigearias, and
Marc Pradines, and
Arnauld Prigent, and
Gil Putterman, and
Marc Rey, and
Mickael Samama, and
Renaud Tamisier, and
Michel Tiberge, and
Cyrille Tison, and
Fabienne Tordjman, and
Bernard Triolet, and
Christian Vacher, and
Marie-Françoise Vecchierini, and
Alain Verain
June 1990,
[Osaka Daigaku shigaku zasshi] The journal of Osaka University Dental Society,
