Obstructive Sleep Apnea Surveillance and Oral Appliance Therapy Evaluation, Active Duty US Army, 2014-2019

Study Objectives: Determine the incidence of obstructive sleep apnea (OSA) among United States Army soldiers from 2014 through 2019 and assess self-reported impacts of the disorder and one of its treatments-oral appliance therapy. Methods: Surveillance data were obtained from the Armed Forces Health Surveillance Division; remaining data were self-reported through an electronic survey. Results: There were 87 404 cases of OSA from 2014 through 2019; incidence rates ranged from 274.3 to 330.3 cases per 10 000 personyears (p-yrs). Male incidence rates (from 294.3 to 355.9/10 000 p-yrs) exceeded female incidence rates (from 155.2 to 189.2/10 000 pyrs). Soldiers 40 years old had the highest incidence rates (from 820.1 to 973.2/10 000 p-yrs). The survey was completed by 8740 soldiers. The majority reported positive airway pressure therapy as their current treatment method; 9% (n=795) reported treatment with an oral appliance. Comparing pretreatment to post-treatment, respondents treated with the oral appliance reported statistically significant improvements in sleep quality, duration, and various aspects of daily life. The predominance (76%) of those treated with anything other than the oral appliance reported they were not aware of the oral appliance as a treatment method. Conclusion: Results suggest soldiers are satisfied with the oral appliance; it has significantly improved their sleep quality, duration, and various aspects of daily life. Clinical Implications: Military dentists can support a streamlined process to diagnose and treat OSA. The required yearly dental exam provides an opportunity to screen soldiers for OSA and discuss the lesser-known treatment-oral appliance therapy.