Effect on Sleep Quality and Daytime Functioning with O2 Vent Optima Oral Appliance and Expiratory Positive Pressure Accessory (ExVent) in Obstructive Sleep Apnea Patients

Author(s): Sat Sharma, Antonella Conflitti, Hilary Reiter, Ivan Valcarenghi, Barry Weinstein, Shideh Pejman, Brian Smith, Adam Teo, Bob Gibbons

Study Objectives: ExVent is an optional accessory for the O2Vent Optima mandibular advancement device that provides oral expiratory positive airway pressure (EPAP). Similar to nasal EPAP, oral EPAP results in passive upper airway dilatation and reduces flow limitation. Long-term benefits of combination therapy on sleep quality, excessive daytime sleepiness, daytime functioning and quality of bed partner’s sleep with the combination therapy require further study.

Methods: A retrospective survey was conducted of all patients who received O2Vent Optima MAD and ExVent in Canada and Australia since 2019. Data collected included: demographics, duration and frequency of use, excessive daytime sleepiness, reported snoring, sleep satisfaction, morning and daytime functioning, daytime tiredness/fatigue and bed partner’s sleep interruption.

Results: Out of 480 patients, 168 (35%) contacted and participated. 31 (18%) had stopped using oral appliance. Out of 137 (81%) subjects, 118 (86%) were still using ExVent Accessory, 108 (92%) used medium strength ExVent. Mean use duration was 2.7±0.9 years, mean use frequency – most nights (91%) and mean use >6 hours/night (86%). Daytime sleepiness improved to none/mild from moderate/severe (96%, p<0.05). Reported snoring improved to none/mild from moderate/severe (94%, p<0.05). Participants slept very well/reasonably well compared to not well/not well at all (82%, p<0.05), woke up more refreshed most mornings compared to some/rare mornings (86%, p<0.05), functioned very well/reasonably to not well/not well at all (88%, p<0.05), felt fatigue and tiredness none of the time compared to some/all the time (83%, p<0.05), bed partner’s sleep interruption was none/some of the time from all the time (95%, p<0.05).

Conclusions: Majority of the patients with mild to moderate OSA treated with O2Vent Optima and ExVent were compliant, experienced improved snoring, sleep quality, daytime functioning and uninterrupted bed partner’s sleep.

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