Investigation of supine dependent OSA as a predictor of successful treatment with MAD

Background: Several factors are associated with successful treatment of mild to moderate OSA with a mandibular advancement device (MAD). Data about the predictive value of supine-dependent OSA are conflicting. Very little literature is available about the predictive value of the AHI in supine position. Here, we investigate supine dependent OSA and AHI in supine position as predictors of successful treatment with MAD. Methods: From January 1, 2015 until December 31, 2017, patients with OSA with an AHI >5 and <30 receiving an MAD were included. Successful treatment was defined as a decrease of AHI with MAD of at least 50% and AHI <10/hour. Results: 118 patients were included, 78.8% had supine dependent OSA, 21.2% had non-supine dependent OSA. Successful treatment was achieved in 44% of the patients with supine dependent OSA, versus 28% of patients with non-supine dependent OSA, p=0.12. With linear regression, the only independent predictor of success was BMI. No relations were found between success and supine dependent OSA or AHI in supine position. Conclusion: In our cohort, supine dependent and AHI in supine position were not predicting factors for successful treatment of mild to moderate OSA with MAD.