Assessment of the Oxygen Desaturation Index During Treatment of Obstructive Sleep Apnea by Limited Mandibular Advancement

Oral appliance therapy (OAT) has gained increasing recognition as a treatment of obstructive sleep apnea (OSA) in holding the mandible to in anterior position. Currently, appliances are titrated based on patients reports of improvement in symptoms with reduction in snoring and daytime sleepiness. Oxygen Desaturation Index (ODI) has the potential to provide objective insight into the therapeutic effect of incremental advancement in oral appliance therapy. Participants were identified through electronic health record as having undergone a sleep study, diagnosed with OSA, and referred for OAT. Participants were fitted for oral appliances in comfortable protruded positions and were assessed for improvement of ODI compared to baseline values. Means and associated standard deviations (SD) were used to summarize continuous data. A total of 5 individuals were included in the analyses. Means and associated standard deviations (SD) were used to summarize continuous data. Numerically, both ODI minimal SpO2 improved with mandibular advancement. Average ODI improvement over titration was -13% (SD 5%, Range -8% to -21%). Oxygen Desaturation Index (ODI) collected periodically during the oral appliance titration has the potential to provide objective measure of treatment efficacy of obstructive sleep apnea in the military population. Further research is needed to validate the improvement in ODI to reduction in AHI with oral appliance therapy.