Evidence Brief References

Oral Appliance Therapy Treats Obstructive Sleep Apnea, Reduces Blood Pressure and Improves Quality of Life

1. Vecchierini MF, Attali V, Collet JM, et al. Mandibular advancement device use in obstructive sleep apnea: ORCADES study 5-year follow-up data. J Clin Sleep Med. 2021;17(8):1695-1705.
2. de Vries GE, Wijkstra PJ, Houwerzijl EJ, Kerstjens HAM, Hoekema A. Cardiovascular effects of oral appliance therapy in obstructive sleep apnea: A systematic review and meta-analysis. Sleep Med Rev. 2018 Aug;40:55-68.
3. Ou YH, Colpani JT, Cheong CS, et al. Mandibular Advancement vs CPAP for Blood Pressure Reduction in Patients With Obstructive Sleep Apnea. J Am Coll Cardiol. 2024 May 7;83(18):1760-1772. 
4. Ucak S, Dissanayake HU, Sutherland K, Bin YS, de Chazal P, Cistulli PA. Effect of mandibular advancement splint therapy on cardiac autonomic function in obstructive sleep apnoea. Sleep Breath. 2024 Mar;28(1):349-357. 
5. Yu M, Ma Y, Han F, Gao X. Long-term efficacy of mandibular advancement devices in the treatment of adult obstructive sleep apnea: A systematic review and meta-analysis. PLoS One. 2023 Nov 28;18(11):e0292832.
6. Tegelberg A, Wilhelmsson B, Erixon-Lindroth N, Lindström LH. Improved cognitive functions after treatment with an oral appliance in obstructive sleep apnea. Nat Sci Sleep. 2012;4:89-96.
7. Naismith SL, Winter VR, Hickie IB, Cistulli PA. Effect of oral appliance therapy on neurobehavioral functioning in obstructive sleep apnea: a randomized controlled trial. J Clin Sleep Med. 2005;1(4):374-80.
   
   

Patients Adhere to Oral Appliance Therapy

1. Vanderveken OM, Dieltjens M, Wouters K, De Backer WA, Van De Heyning PH, Braem MJ. Objective measurement of compliance during oral appliance therapy for sleep-disordered breathing. Thorax. 2013;68(1):91-96. doi:10.1136/thoraxjnl-2012-201900
2. Bachour P, Bachour A, Kauppi P, Maasilta P, Mäkitie A, Palotie T. Oral appliance in sleep apnea treatment: respiratory and clinical effects and long-term adherence. Sleep Breath. 2016;20(2):805-812. doi:10.1007/s11325-015-1301-0
3. Tallamraju H, Newton JT, Fleming PS, Johal A. Factors influencing adherence to oral appliance therapy in adults with obstructive sleep apnea: a systematic review and meta-analysis. J Clin Sleep Med. 2021;17(7):1485-1498. 

Oral Appliance Therapy is an Effective Alternative to CPAP

1. Sutherland K, Phillips CL, Cistulli PA. Efficacy versus effectiveness in the treatment of obstructive sleep apnea: CPAP and oral appliances. J Dent Sleep Med. 2015;2(4):175–181.
2. Phillips CL, Grunstein RR, Darendeliler MA, et al. Health outcomes of continuous positive airway pressure versus oral appliance treatment for obstructive sleep apnea: a randomized controlled trial. Am J Respir Crit Care Med. 2013;187(8):879-87.
3. Aarab G, Lobbezoo F, Hamburger HL, Naeije M. Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea: a randomized, placebo-controlled trial. Respiration. 2011;81(5):411-9.
4. Ou YH, Colpani JT, Cheong CS, et al. Mandibular Advancement vs CPAP for Blood Pressure Reduction in Patients With Obstructive Sleep Apnea. J Am Coll Cardiol. 2024;83(18):1760-1772.
5. Trzepizur W, Cistulli PA, Glos M, et al. Health outcomes of continuous positive airway pressure versus mandibular advancement device for the treatment of severe obstructive sleep apnea: an individual participant data meta-analysis. Sleep . January 2021.
6. Gagnadoux F, Fleury B, Vielle B, et al. Titrated mandibular advancement versus positive airway pressure for sleep apnea. Eur Respir J. 2009;34(4):914-920.

Custom Oral Appliances are More Effective than Non-custom Appliances 

1. Uniken Venema JAM, Rosenmöller BRAM, de Vries N, et al. Mandibular advancement device design: A systematic review on outcomes in obstructive sleep apnea treatment. Sleep Med Rev. 2021;60:101557.
2. van der Hoek LH, Rosenmöller BRAM, van de Rijt LJM, de Vries R, Aarab G, Lobbezoo F. Factors associated with treatment adherence to mandibular advancement devices: a scoping review. Sleep Breath. 2023 Dec;27(6):2527-2544.
3. Manetta IP, Ettlin D, Sanz PM, Rocha I, Meira E Cruz M. Mandibular advancement devices in obstructive sleep apnea: an updated review. Sleep Sci. 2022 Apr-Jun;15(Spec 2):398-405.

Oral Appliance Therapy Can Be Effectively Combined with Other Therapies

1. Liu HW, Chen YJ, Lai YC, et al. Combining MAD and CPAP as an effective strategy for treating patients with severe sleep apnea intolerant to high-pressure PAP and unresponsive to MAD. Kou YR, ed. PLoS One. 2017;12(10):e0187032.
2. Aishah A, Tong BKY, Osman AM, et al. Stepwise Add-On and Endotype-informed Targeted Combination Therapy to Treat Obstructive Sleep Apnea: A Proof-of-Concept Study. Ann Am Thorac Soc. 2023;20(9):1316-1325.
3. Parthasarathy S, Ayas NT, Bogan R, et al. Oral appliance therapy and hypoglossal nerve stimulation as non-positive airway pressure treatment alternatives for obstructive sleep apnea: a narrative expert review. Sleep Adv. 2024;5(1):zpae035.
4. Huang W, Li C, Zou J, Wang X, Zhang J, Guan J, Yi H, Yin S. Effects of the combination of novel eye mask sleep position therapy device and oral appliance on positional OSA: A multi-arm, parallel-group randomized controlled trial. Sleep Med. 2023;102:52-63.