ArticleThe Journal of physiology2019
Structure and severity of pharyngeal obstruction determine oral appliance efficacy in sleep apnoea.
Article in The Journal of physiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Oral appliances for obstructive sleep apnoea in adults.The Cochrane database of systematic reviews · 2026Pooled it
- Mandibular Advancement Device Treatment Efficacy Is Associated with Polysomnographic Endotypes.Annals of the American Thoracic Society · 2021Trial
- Site of Collapse during Drug-induced Sleep Endoscopy Is Associated with Polysomnographic Endotypic Traits: An Observational Study.Annals of the American Thoracic Society · 2025Observational
- Research Priorities for Translating Endophenotyping of Adult Obstructive Sleep Apnea to the Clinic: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2025Article
- Is Obstructive Sleep Apnea in People Without Obesity a Unique Disease?Archivos de bronconeumologia · 2025Article
- Unmasking the hidden risks: clinical implications of 4 premolar extraction orthodontics on health and upper airway dynamics.Evidence-based dentistry · 2025Article
- Phenotypes of Velopharyngeal Tube Law in Obstructive Sleep Apnea.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2025Article
- Polysomnographic airflow shapes and site of collapse during drug-induced sleep endoscopy.The European respiratory journal · 2024Article
- A mandibular advancement device associated with lingual control: a new treatment option for obstructive sleep apnea?Sleep & breathing = Schlaf & Atmung · 2024Article
- Sleep Apnea Physiological Burdens and Cardiovascular Morbidity and Mortality.American journal of respiratory and critical care medicine · 2023Article
- Association of cortical arousals with sleep-disordered breathing events.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023Article
- Mandibular advancement reduces pharyngeal collapsibility by enlarging the airway rather than affecting velopharyngeal compliance.Physiological reports · 2023Article
- Innovations in mandibular advancement splint therapy for obstructive sleep apnoea.Frontiers in sleep · 2023Review
- Mandibular advancement device therapy in patients with epiglottic collapse.Sleep & breathing = Schlaf & Atmung · 2022Article
- Non-CPAP therapy for obstructive sleep apnoea.Breathe (Sheffield, England) · 2022Review
- Clinical polysomnographic methods for estimating pharyngeal collapsibility in obstructive sleep apnea.Sleep · 2022Article
- Critical closing pressure of the pharyngeal airway during routine drug-induced sleep endoscopy: feasibility and protocol.Journal of applied physiology (Bethesda, Md. : 1985) · 2022Article
- In-home mandibular repositioning during sleep using MATRx plus predicts outcome and efficacious positioning for oral appliance treatment of obstructive sleep apnea.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Article
- The Site of Airway Collapse in Sleep Apnea, Its Associations with Disease Severity and Obesity, and Implications for Mechanical Interventions.American journal of respiratory and critical care medicine · 2021Article
- Mandibular Advancement Devices for OSA: An Alternative to CPAP?Pulmonary therapy · 2021Review
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Authors and funding
10 authors at 3 institutions in 5 countries.
Funding
Abstract
key points•Some patients with obstructive sleep apnoea (OSA) respond well to oral appliance therapy, whereas others do not for reasons that are unclear. •In the present study, we used gold-standard measurements to demonstrate that patients with a posteriorly-located tongue (natural sleep endoscopy) exhibit a preferential improvement in collapsibility (lowered critical closing pressure) with oral appliances. •We also show that patients with both posteriorly-located tongue and less severe collapsibility (predicted responder phenotype) exhibit greater improvements in severity of obstructive sleep apnoea (i.e. reduction in event frequency by 83%, in contrast to 48% in predicted non-responders). •The present study suggests that the structure and severity of pharyngeal obstruction determine the phenotype of sleep apnoea patients who benefit maximally from oral appliance efficacy. ABSTRACT: A major limitation to the administration of oral appliance therapy for obstructive sleep apnoea (OSA) is that therapeutic responses remain unpredictable. In the present study, we tested the hypotheses that oral appliance therapy (i) reduces pharyngeal collapsibility preferentially in patients with posteriorly-located tongue and (ii) is most efficacious (reduction in apnoea-hypopnea index; AHI) in patients with a posteriorly-located tongue and less-severe baseline pharyngeal collapsibility. Twenty-five OSA patients underwent upper airway endoscopy during natural sleep to assess tongue position (type I: vallecula entirely visible; type II: vallecula obscured; type III: vallecula and glottis obscured), as well as obstruction as a result of other pharyngeal structures (e.g. epiglottis). Additional sleep studies with and without oral appliance were performed to measure collapsibility (critical closing pressure; Pcrit) and assess treatment efficacy. Overall, oral appliance therapy reduced Pcrit by 3.9 ± 2.4 cmH
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.