{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T18:30:41Z","timestamp":1770489041952,"version":"3.49.0"},"reference-count":31,"publisher":"BMJ","issue":"5","funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016275","name":"Seoul National University Bundang Hospital","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100016275","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,3,23]]},"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify adequate criteria to determine the success or failure of mandibular advancement device (MAD) treatment for obstructive sleep apnoea (OSA) based on long-term symptoms and new-onset hypertension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Observational cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A tertiary care hospital setting in South Korea.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Patients (age &gt;18 years) who were diagnosed with OSA by a polysomnography (PSG) or Watch peripheral arterial tonometry (PAT), and who had been treated with MAD between January 2007 and December 2014 were enrolled.<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary and secondary outcome measures<\/jats:title><jats:p>Patients underwent PSG or Watch PAT twice; before and 3 months after the application of MAD. The patients were categorised into success and failure groups using seven different criteria. MAD compliance, witnessed apnoea and snoring, Epworth Sleepiness Scale score and occurrence of new-onset hypertension were surveyed via telephonic interview to determine the criteria that could identify success and failure of MAD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 97 patients were included. The mean follow-up duration was 60.5 months, and the mean apnoea\u2013hypopnoea index (AHI) was 35.5\/hour. Two of the seven criteria could significantly differentiate the success and failure groups based on long-term symptoms, including (1) AHI&lt;10\/hour with MAD and (2) AHI&lt;10\/hour and AHI reduction of &gt;50% with MAD. Kaplan-Meier survival analysis showed that one criterion of AHI&lt;15\/hour with MAD could differentiate the success and failure groups based on new-onset hypertension (p=0.035). The receiver operating characteristic curve analysis indicated that the cut-off AHI for new-onset hypertension was 16.8\/hour (71.4% sensitivity and 75.0% specificity).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our long-term follow-up survey for symptoms and new-onset hypertension suggested that some of the polysomnographic success criteria, that is, AHI&lt;10\/hour with MAD, AHI&lt;10\/hour and AHI reduction of &gt;50% with MAD and AHI&lt;15\/hour with MAD may be useful in distinguishing the success group from failure one. Further prospective longitudinal studies are warranted to validate these criteria.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2018-021644","type":"journal-article","created":{"date-parts":[[2018,5,8]],"date-time":"2018-05-08T07:55:18Z","timestamp":1525766118000},"page":"e021644","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Comparison of success criteria based on long-term symptoms and new-onset hypertension in mandibular advancement device treatment for obstructive sleep apnoea: observational cohort study"],"prefix":"10.1136","volume":"8","author":[{"given":"Jee Hye","family":"Wee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae Hyun","family":"Lim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"January E","family":"Gelera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chae-Seo","family":"Rhee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeong-Whun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,5,8]]},"reference":[{"key":"2024051712402045000_8.5.e021644.1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01618-2015"},{"key":"2024051712402045000_8.5.e021644.2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.189420"},{"key":"2024051712402045000_8.5.e021644.3","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000000336","article-title":"Obstructive sleep apnea and serious adverse outcomes in patients with cardiovascular or cerebrovascular disease: a PRISMA-compliant systematic review and meta-analysis","volume":"93","author":"Xie","year":"2014","journal-title":"Medicine"},{"key":"2024051712402045000_8.5.e021644.4","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.5665\/sleep.4086","article-title":"Combined effects of sleep disordered breathing and metabolic syndrome on endothelial function: the Wisconsin Sleep Cohort study","volume":"37","author":"Korcarz","year":"2014","journal-title":"Sleep"},{"key":"2024051712402045000_8.5.e021644.5","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.sleep.2016.02.008","article-title":"A review of neurocognitive function and obstructive sleep apnea with or without daytime sleepiness","volume":"23","author":"Zhou","year":"2016","journal-title":"Sleep Med"},{"key":"2024051712402045000_8.5.e021644.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200005113421901"},{"key":"2024051712402045000_8.5.e021644.7","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.163.1.2001008"},{"key":"2024051712402045000_8.5.e021644.8","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000042706.47107.7A"},{"key":"2024051712402045000_8.5.e021644.9","doi-asserted-by":"crossref","first-page":"263","DOI":"10.5664\/jcsm.27497","article-title":"Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults","volume":"5","author":"Epstein","year":"2009","journal-title":"J Clin Sleep Med"},{"key":"2024051712402045000_8.5.e021644.10","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-012-0739-6"},{"key":"2024051712402045000_8.5.e021644.11","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201212-2223OC"},{"key":"2024051712402045000_8.5.e021644.12","doi-asserted-by":"crossref","first-page":"773","DOI":"10.5664\/jcsm.4858","article-title":"Clinical practice guideline for the treatment of obstructive sleep apnea and snoring with oral appliance therapy: an update for 2015","volume":"11","author":"Ramar","year":"2015","journal-title":"J Clin Sleep Med"},{"key":"2024051712402045000_8.5.e021644.13","doi-asserted-by":"crossref","first-page":"165","DOI":"10.5664\/jcsm.2420","article-title":"Effect of oral appliances on blood pressure in obstructive sleep apnea: a systematic review and meta-analysis","volume":"9","author":"Iftikhar","year":"2013","journal-title":"J Clin Sleep Med"},{"key":"2024051712402045000_8.5.e021644.14","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.16303"},{"key":"2024051712402045000_8.5.e021644.15","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.sleep.2013.12.007","article-title":"Selection of response criteria affects the success rate of oral appliance treatment for obstructive sleep apnea","volume":"15","author":"Fukuda","year":"2014","journal-title":"Sleep Med"},{"key":"2024051712402045000_8.5.e021644.16","doi-asserted-by":"crossref","first-page":"35","DOI":"10.5664\/jcsm.5388","article-title":"A Comparison of different success definitions in non-continuous positive airway pressure treatment for obstructive sleep apnea using cardiopulmonary coupling","volume":"12","author":"Lee","year":"2016","journal-title":"J Clin Sleep Med"},{"key":"2024051712402045000_8.5.e021644.17","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/147.4.887"},{"key":"2024051712402045000_8.5.e021644.18","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1093\/sleep\/7.2.110","article-title":"Effect of sleep position on sleep apnea severity","volume":"7","author":"Cartwright","year":"1984","journal-title":"Sleep"},{"key":"2024051712402045000_8.5.e021644.19","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1093\/sleep\/19.2.156","article-title":"The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome","volume":"19","author":"Sher","year":"1996","journal-title":"Sleep"},{"key":"2024051712402045000_8.5.e021644.20","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1093\/sleep\/34.1.105","article-title":"Reliable calculation of the efficacy of non-surgical and surgical treatment of obstructive sleep apnea revisited","volume":"34","author":"Ravesloot","year":"2011","journal-title":"Sleep"},{"key":"2024051712402045000_8.5.e021644.21","doi-asserted-by":"publisher","DOI":"10.1016\/S1389-9457(01)00072-7"},{"key":"2024051712402045000_8.5.e021644.22","first-page":"894","article-title":"Clinical parameters in obstructive sleep apnea: are there any correlations?","volume":"37","author":"Thong","year":"2008","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"2024051712402045000_8.5.e021644.23","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24275"},{"key":"2024051712402045000_8.5.e021644.24","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1093\/sleep\/30.4.461","article-title":"Redefining success in airway surgery for obstructive sleep apnea: a meta analysis and synthesis of the evidence","volume":"30","author":"Elshaug","year":"2007","journal-title":"Sleep"},{"key":"2024051712402045000_8.5.e021644.25","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.160.6.9811054"},{"key":"2024051712402045000_8.5.e021644.26","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7233.479"},{"key":"2024051712402045000_8.5.e021644.27","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200712-1809OC"},{"key":"2024051712402045000_8.5.e021644.28","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2009.31"},{"key":"2024051712402045000_8.5.e021644.29","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2012.452"},{"key":"2024051712402045000_8.5.e021644.30","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13-0613"},{"key":"2024051712402045000_8.5.e021644.31","doi-asserted-by":"crossref","first-page":"339","DOI":"10.5664\/jcsm.2584","article-title":"Reliability of the Watch-PAT 200 in detecting sleep apnea in highway bus drivers","volume":"9","author":"Yuceege","year":"2013","journal-title":"J Clin Sleep Med"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-021644","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T21:58:59Z","timestamp":1715983139000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-021644"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5]]},"references-count":31,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2018,5,8]]},"published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1136\/bmjopen-2018-021644"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-021644","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5]]}}}