A prospective 8 week trial of nasal interfaces vs. a novel oral interface (Oracle™) for treatment of obstructive sleep apnea hypopnea syndrome

Abstract 

Objective: To compare efficacy, compliance rates, and side effects of a new strapless oral interface, the Oracle™, with available nasal masks over 8 weeks of use for the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: A total of 38 patients with OSAHS (respiratory disturbance index (RDI) ≥15/h) were enrolled after the diagnostic polysomnogram for subsequent continuous positive airway pressure (CPAP) therapy. After randomization, therapeutic pressures during a titration study were determined for 21 patients in the oral group and 17 patients in the nasal group. Comparisons for nasal and oral interfaces were made for baseline patient characteristics, average hours of CPAP use, side effects from therapy, and among questionnaires evaluating patients' subjective responses to therapy at months 1 and 2. Results: No significant difference was observed in the average hours of CPAP use between the oral (4.5±2.1; 5.5±2.6) and nasal groups (4.0±2.6; 4.8±2.5) for either month 1 or 2 (P>0.05). The dropout rates were similar for both groups after 8 weeks of therapy. However, patients in the nasal group had higher occurrences of side effects such as nasal congestion, dryness, and air leaks, whereas patients in the oral group experienced more oral dryness and gum pain. Conclusion: Oral delivery of CPAP with the Oracle™ is an effective and suitable alternative for patients with OSAHS.

Keywords:  Obstructive sleep apnea hypopnea syndrome, Continuous positive airway pressure, Compliance, Nasal masks, Oracle, Oral continuous positive airway pressure, Nasal continuous positive airway pressure