Disparities in oxygen saturation and hypoxic burden levels in obstructive sleep apnoea patient’s response to oral appliance treatment

Abstract

Abstract Background Oxygen saturation indices show a strong correlation with long‐term health outcomes. Nonetheless, evidence on the relationship between reduction in respiratory events and increase in oxygenation levels following oral appliance (OA) treatment is scarce. Objectives To verify the relationship between reduction in the apnoea‐hypopnoea index (AHI) and oxygen saturation levels following OA treatment, we have conducted an evaluation of polysomnography (PSG) and clinical parameters associated with the improvement of oxygen desaturation. Methods OSA patients ( n = 48) who received an OA and had pre‐ and post‐treatment PSG were classified into three responder groups according to the change in AHI and min O 2 post‐treatment: responder AHIonly (decrease in AHI of ≥50% but increase in min O 2 level of <4% or decrease); responder MinO2only (increase in min O 2 level of ≥4% but decrease in AHI <50% or increase) and responder Congruous (decrease in AHI of ≥50% and increase in min O 2 level of ≥4%). Various demographic and PSG variables were statistically compared among groups. Results There were 26 (54.17%) responder AHIonly , 9 (18.75%) responder MinO2only and 13 (27.08%) responder Congruous . Pre‐treatment min O 2 was significantly lower in responder MinO2only . A higher pre‐treatment min O 2 showed a significant correlation with a smaller amount of change in mean O 2 ( r = −.486) and min O 2 ( r = −.764) with treatment. Pre‐treatment min O 2 showed the strongest ability to predict those who would show a ≥4% min O 2 increase following treatment. Conclusion Certain patients do not show sufficient decrease in hypoxaemia in spite of the improvement in AHI. Pre‐treatment min O 2 should be considered in OA treatment planning regarding its close relation to improvements in oxygenation levels with treatment.

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