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Peer-Reviewed Study

2025

Patient Selection for Efficacious Mandibular Advancement Device Therapy in Obstructive Sleep Apnea: An Institutional Outcomes Analysis

Author(s): Nainika Nanda, MD, Aaron Robertson, MD, and David C. Upton, MD
Published in Annals of Otology, Rhinology & Laryngology.

Summary

Devices Used: dreamTAP
Researchers reviewed 86 adults (mostly middle-aged, with a mix of men and women) at a university hospital who had moderate to severe OSA and couldn’t tolerate CPAP. These patients had specific airway issues (rated as Friedman Stages 2-4, meaning surgery might not be ideal). They got fitted with the TAP device, adjusted it over time for comfort, and did sleep tests before and after. Key Results:
  • Overall, the device worked well: 72% of patients saw major improvement—either cutting their apnea events (measured by AHI score) by at least 50%, or dropping to mild levels (under 15 events per hour).
  • On average, apnea events dropped by about 10 per hour (from 20 to 9), and the lowest oxygen levels during sleep improved by nearly 2%.
  • It helped across all severity levels: 56% success in mild cases, 85% in moderate, and 75% in severe.
  • Common worries like high weight (BMI), older age, being male, previous throat surgery, or certain airway collapse patterns didn’t stop it from working for most people. (One positive note: a front-back collapse pattern in the throat led to even better oxygen improvements.)
The study suggests TAP is a solid first-choice option for these patients, especially if CPAP isn’t an option, and it’s easy to tolerate long-term. It’s not perfect for everyone (as about 28% didn’t respond fully), and more research is needed, but it’s a non-invasive, adjustable tool that could improve sleep and health without surgery.
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