ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2021
Mandibular advancement device use in obstructive sleep apnea: ORCADES study 5-year follow-up data.
Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 18 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Obstructive Sleep Apnea Non-PAP Outcomes and Viable Alternatives (OSANOVA): Comparison of Mandibular Advancement Device and Hypoglossal Nerve Stimulation Outcomes
Reducing Obstructive Sleep Apnea After Hypoglossal Nerve Stimulation Through
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Continuous Positive Airway Pressure Versus Mandibular Advancement Devices Impact on Cardio-Metabolic Outcomes in Patients With Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.Journal of sleep research · 2026Pooled it
- Worldwide prevalence and associated risk factors of obstructive sleep apnea: a meta-analysis and meta-regression.Sleep & breathing = Schlaf & Atmung · 2023Pooled it
- Polygraphic evaluation of the effects of functional orthodontic treatment with twin block and herbst appliances on sleep quality: a randomized clinical trial.Sleep & breathing = Schlaf & Atmung · 2026Trial
- Trial
- Comparative effects of CPAP and mandibular advancement devices in obstructive sleep apnea: an overview of systematic reviews.Sleep & breathing = Schlaf & Atmung · 2026Review
- Effect of sleep apnoea interventions on multiple health outcomes: an umbrella review of meta-analyses of randomised controlled trials.EClinicalMedicine · 2025Article
- Using DISE to evaluate tonsillar obstruction in sleep apnea syndrome in adults.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025Article
- Challenges in Obstructive Sleep Apnea Management in Elderly Patients.Journal of clinical medicine · 2024Review
- Evaluation of arterial stiffness and quality of life in the treatment of moderate to severe obstructive sleep apnea with Continuous Positive Airway Pressure or Mandibular Advancement Appliance: a cross-sectional study.BMC cardiovascular disorders · 2024Article
- Mandibular advancement device in obstructive sleep apnea treatment: what happens to the condyle position and patient response?Sleep & breathing = Schlaf & Atmung · 2024Observational
- Automatic prediction of obstructive sleep apnea in patients with temporomandibular disorder based on multidata and machine learning.Scientific reports · 2024Article
- Evolution of adherence and self-reported symptoms over 36 months with mandibular advancement device therapy for obstructive sleep apnea: a retrospective study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- Oral appliance therapy and hypoglossal nerve stimulation as non-positive airway pressure treatment alternatives for obstructive sleep apnea: a narrative expert review.Sleep advances : a journal of the Sleep Research Society · 2024Article
- The role of oral appliance therapy in obstructive sleep apnoea.European respiratory review : an official journal of the European Respiratory Society · 2023Review
- Maxillomandibular Advancement and Upper Airway Stimulation for Treatment of Obstructive Sleep Apnea: A Systematic Review.Journal of clinical medicine · 2022Review
- Current and novel treatment options for obstructive sleep apnoea.ERJ open research · 2022Review
- Obstructive sleep apnea therapy for cardiovascular risk reduction-Time for a rethink?Clinical cardiology · 2021Review
- Is it the time to expect long-term outcome data in addition to follow-up data for sleep apnea interventions?Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021Article
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesMandibular advancement devices (MADs) are an alternative to continuous positive airway pressure for the management of obstructive sleep apnea (OSA). The ORthèse d'avanCée mAndibulaire dans le traitement en DEuxième intention du SAHOS sévère (ORCADES) study is investigating the long-term effectiveness of MAD therapy in patients with OSA who refused or were intolerant of continuous positive airway pressure. Five-year follow-up data are presented.
methodsData were available in 172 of 331 patients treated with a custom-made computer-aided design/computer-aided manufacturing biblock MAD (Narval CC; ResMed, Saint-Priest, France). The primary end point was treatment success (≥50% decrease in apnea-hypopnea index from baseline).
resultsFive-year treatment success rates were 52% overall and 25%, 52%, and 63%, respectively, in patients with mild, moderate, or severe OSA. This reflects a decline over time vs 3-6 months (79% overall) and 2 years (68%). Rates declined in all patient subgroups but to the greatest extent in patients with mild OSA. The slight worsening of respiratory parameters over time was not associated with any relevant changes in sleepiness and symptoms. Moderate or severe OSA at baseline, treatment success at 3-6 months, and no previous continuous positive airway pressure use were significant independent predictors of 5-year treatment success on multivariate analysis. No new safety signals emerged during long-term follow-up. The proportion of patients using their MAD for ≥4 h/night on ≥4 days/wk was 93.3%; 91.3% of patients reported device use of ≥6 h/night at 5 years. At 5-year follow-up, 96.5% of patients reported that they wanted to continue MAD therapy.
conclusionsLong-term MAD therapy remained effective after 5 years in >50% of patients, with good levels of patient satisfaction and adherence. CITATION: Vecchierini MF, Attali V, Collet JM, et al. Mandibular advancement device use in obstructive sleep apnea: ORCADES study 5-year follow-up data.
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