Clinical Update quiz
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Each month, the Clinical Update is published online. There are 11 Clinical Updates per year (February - December). This service is available to ADAVB and ADATas members only. Members can log in to view and answer the Clinical Update questions. If you answer at least eight out of 10 questions correctly, you will receive one hour of scientific CPD.
Please note: Each new Clinical Update will be available below from the first business day of each month.
June Clinical Update
ORCADES Study: Five-year evaluation of mandibular advancement device efficacy in obstructive sleep apnea1 management
Vecchierini MF et al. Mandibular advancement device use in obstructive sleep apnea1: ORCADES study 5-year follow-up data. J Clin Sleep Med. 2021 Aug 1;17(8):1695-1705.
Compiled by Dr Nirav Bhatia
This article was originally published by the Journal of Clinical Sleep Medicine and has been edited for brevity and clarity.
Introduction
Nasal continuous positive airway pressure (CPAP) is the first-choice treatment for severe obstructive sleep apnea1 (OSA), but long-term adherence is often suboptimal. Oral appliances offer an alternative option for managing OSA, the most common of which are mandibular advancement devices (MADs).
MADs bring the mandible forward, advance the tongue and enlarge the retropalatal airway via an increase in its lateral diameter, thereby increasing upper airway volume, decreasing upper airway closing pressure, and reducing the tendency of the upper airway to collapse. Advantages of MADs over CPAP include simplicity, portability, and patient acceptance. Although the efficacy of MADs for reducing the frequency of obstructive events is lower than that of CPAP, their overall effectiveness is similar because of better adherence to treatment.
The ORCADES study investigated the long-term effectiveness of MAD therapy in patients with CPAP-naive OSA and in patients who were intolerant of CPAP therapy. This analysis presents 5-year follow-up data for patients with OSA treated with MAD.
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