Methods: A mail questionnaire was sent to 544 snoring/OSA patients who had worn an oral appliance.
Results: Some 44.8% of the patients returned the questionnaire, 39.1% did not, 15% had an invalid address and 0.9% were deceased. Of the returned sample, 63.5% were still wearing their OA (G1). There was no significant difference in the Apnea and Hypopnea Index between the returned and not-returned groups, or between patients who had stopped wearing the OA (G2) and G1. Snoring was satisfactorily controlled in 78.5% of G1 and in 41% of G2. Within the G1 group, 92.6% used the OA more than 4 nights/week, 100% wore it more than half of each night that it was used and 95.4% were satisfied with the treatment. The most frequent reasons why patients discontinued wearing the OA were that it was uncomfortable (44.9%), it had little or no effect (36%), they had switched to Nasal Continuous Positive Airway Pressure (23.6%) or they had experienced a dry mouth (20.2%). Excessive salivation occurred more often in G1. Other side effects such as dry mouth and tooth and/or jaw discomfort were more frequent and more severe in G2 (p<0.05). With OA usage, both G1 and G2 groups reported an increase in TMJ symptoms and a significant improvement in the Epworth Sleepiness Scale (p<0.01) but there was no difference in the amount of change for either variable.
Conclusion: Subjects who wore an OA reported good compliance and that their sleepiness was adequately controlled. A dry mouth, tooth and/or jaw discomfort and less improvement of snoring may be possible reasons why some patients may stop wearing their OA.