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Abstract Introduction The ExVent is an optional accessory to the O2Vent Optima mandibular advancement device (MAD) and provides oral Expiratory Positive Airway Pressure (EPAP). Oral EPAP with the ExVent is designed to provide upper airway support via similar mechanisms of action of nasal EPAP devices in commercial distribution, e.g., passive dilatation of the airway, which reduces flow limitation. The oral EPAP provided by the ExVent accessory augments the OSA therapy provided by the O2Vent Optima. Long-term benefits on sleep quality and daytime functioning with combination therapy have not been studied. Methods We conducted a retrospective survey of all patients who were prescribed O2Vent Optima mandibular device and oral expiratory positive pressure accessory in Canada and Australia from 2019 to November, 2022. A study investigator contacted the participants via telephone and obtained consent to participate. Data collected included: demographics, duration of use, frequency of use, daytime sleepiness, bed partner reported snoring, sleep satisfaction, morning and daytime functioning, daytime tiredness/fatigue and bed partner’s sleep. Results Out of the patient data base of 480 subject, 168 (35%) participated. 31 (18%) stopped using the appliance. Out of 137 (81%) subjects, 118 (86%) were still using the ExVent Accessory, 92% medium strength (Yellow). Age 53±7 yrs, 76% Male. Data showed mean duration of use 2.7±0.9 years, mean frequency of use - most nights (91%), use 6 hours/night (86%). Sleep quality was compared from before to after therapy. Daytime sleepiness improved to none/mild from moderate/severe (96%). Bed partner reported snoring improved to none/mild from moderate/severe (94%). Participants slept very well/reasonably well compared to not well/not well at all (82%), woke up more refreshed most mornings compared to some/rare mornings (86%), functioned very well/reasonably well to not well/not well at all (88%), felt fatigue and tiredness none of the time compared to some/all the time (83%), bed partner’s sleep interruption was none/some of the time from all the time (95%). Conclusion This retrospective study demonstrated that majority of subjects prescribed EPAP enhanced MAD with O2Vent Optima and ExVent were compliant, experienced improved sleep quality, daytime functioning and their partner’s sleep was significantly less interrupted. Support (if any) Centre for Sleep and Chronobiology, Toronto, Canada
Sharma et al. (Sat,) studied this question.