Mandibular advancement splints, continuous positive airway pressure and a combination of both for the management of obstructive sleep apnea
department or school: Dentistry, Faculty of
data provider: DSpace
degree campus: UBCV
creator: Hamoda, Mona Mohamed Fathy
issued: 2025-05-31T07:00:00Z
issued: 2022
related degree: Doctor of Philosophy - PhD
degree grantor: University of British Columbia
description: Background Obstructive Sleep Apnea (OSA) is a highly prevalent chronic condition that requires lifelong treatment with multidisciplinary management. Continuous-Positive-Airway-Pressure (CPAP) is the first-line treatment and Mandibular-Advancement-Splint (MAS) is a leading alternative. This thesis focuses on these two main treatment modalities for OSA and the overall aim of this work is to address some of the knowledge gaps pertaining to these two treatments in adults. The objectives were to characterize the long-term side-effects of MAS and to assess the comparative effectiveness of CPAP and MAS. Objectives also included an assessment of the two forms of CPAP-MAS combination therapy; both treatments used interchangeably or simultaneously. Additionally, this work aimed to compare these two forms of combination to CPAP and MAS monotherapies. Methods This thesis consists of a literature review (chapter 2) and three clinical trials. Trials include a retrospective trial (chapter 3) assessing long term side-effects of MAS, a cross-over randomized trial (chapter 4) comparing the effectiveness of CPAP, MAS and one form of combination (the interchangeable use of CPAP-MAS). Chapter 5 includes a prospective trial comparing CPAP, MAS and the two forms of combination therapy in a subgroup of participants from the randomized cross-over trial. Results CPAP showed higher efficacy, as indicated by the respiratory event index, compared to MAS (p<0.0001) with mean CPAP-MAS difference (95% confidence interval) of 10.4(7.8-13). MAS showed higher adherence with mean±SD of 7.0±1.2 hours/night of use compared to 5.9±1.6 hours/night of CPAP use (p<0.0001). Both showed comparable effects on blood pressure and patient centered outcomes. The two forms of CPAP-MAS combination showed improved adherence relative to CPAP monotherapy in both trials. Long-term dental side-effects of MAS included significant (p<0.001) maxillary incisor retroclination (mean of ≈6˚) and mandibular incisor proclination …
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/81687
note: MANDIBUAR ADVANCEMENT SPLINTS, CONTINUOUS POSITIVE AIRWAY PRESSURE AND A COMBINATION OF BOTH FOR THE MANAGEMENT OF OBSTRUCTIVE SLEEP APNEA by Mona Mohamed Fathy Hamoda BDS, Alexandria University, 2000 MSc, Alexandria University, 2007 MHSc, The University of British Columbia, 2013 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Craniofacial Science) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) May 2022 © Mona Mohamed Fathy Hamoda, 2022 ii The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, the dissertation entitled: Mandibular Advancement Splints, Continuous Positive Airway Pressure and a Combination of Both for the Management of Obstructive Sleep Apnea submitted by Mona Mohamed Fathy Hamoda in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Craniofacial Science Examining Committee: Dr. Fernanda Almeida, Associate Professor, Department of Oral Health Sciences, UBC Supervisor Dr. Edwin Yen, Professor, Department of Oral Health Sciences, UBC Supervisory Committee Member Dr. Jeremy Road, Professor, Department of Medicine, UBC University Examiner Dr. Bingshuang Zou, Associate Professor, Department of Oral Health Sciences, UBC University Examiner Additional Supervisory Committee Members: Dr. Benjamin Pliska, Associate Professor, Department of Oral Health Sciences, UBC Supervisory Committee Member Dr. Najib Ayas, Associate Professor, Department of Medicine, UBC Supervisory Committee Member iii Abstract Background Obstructive Sleep Apnea (OSA) is a highly prevalent chronic condition that requires lifelong treatment with multidisciplinary management. Continuous-Positive-Airway-Pressure (CPAP) is the first-line treatment and Mandibular-Advancement-Splint (MAS) is a leading alternative. This thesis focuses on these two main treatment modalities for OSA a…
has type: Thesis/Dissertation
date issued: 2022-11
is shown at: 10.14288/1.0413743
language: eng
degree discipline: Craniofacial Science
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
contributor: Almeida, Fernanda
type: Text
identifier URI: http://hdl.handle.net/2429/81687