Open AccessFriedman Score in Relation to Compliance and Treatment Response in Nonsevere Obstructive Sleep Apnea
Author(s) -
Lars Martin Berg,
Torun Karina Solheim Ankjell,
YiQian Sun,
Tordis A. Trovik,
Anders Sjögren,
Oddveig G Rikardsen,
Ketil Moen,
Sølve Hellem,
Vegard Bugten
Publication year - 2020
Publication title -
international journal of otolaryngology
Language(s) - English
Resource type - Journals
eISSN - 1687-921X
pISSN - 1687-9201
DOI - 10.1155/2020/6459276
Subject(s) - medicine , continuous positive airway pressure , obstructive sleep apnea , uvulopalatopharyngoplasty , odds ratio , confidence interval , body mass index , sleep apnea , logistic regression , physical therapy , anesthesia , polysomnography , apnea
Nonsevere obstructive sleep apnea (OSA) is most often treated with a continuous positive airway pressure (CPAP) device or a mandibular advancement splint (MAS). However, patient compliance with these treatments is difficult to predict. Improvement in apnea-hypopnea index (AHI) is also somewhat unpredictable in MAS treatment. In this study, we investigated the association between Friedman tongue position score (Friedman score) and both treatment compliance and AHI improvement in patients with nonsevere OSA receiving CPAP or MAS treatment. 104 patients with nonsevere OSA were randomly allocated to CPAP or MAS treatment and followed for 12 months. Data were collected through a medical examination, questionnaires, sleep recordings from ambulatory type 3 polygraphic sleep recording devices, and CPAP recordings. Associations between Friedman score, treatment compliance, and AHI improvement were analysed with logistic regression analyses. Friedman score was not associated with treatment compliance (odds ratio [OR]: 0.85, 95% confidence interval [CI]: 0.59–1.23), or AHI improvement (OR: 1.05, 95% CI: 0.62–1.76) in the overall study sample, the CPAP treatment group, or the MAS treatment group. Adjustment for socioeconomic factors, body mass index, and tonsil size did not significantly impact the results. Although Friedman score may predict OSA severity and contribute to the prediction of success in uvulopalatopharyngoplasty, we found no association between Friedman score and treatment compliance in patients with nonsevere OSA receiving CPAP or MAS treatment, nor did we find any association between Friedman score and AHI improvement. Factors other than Friedman score should be considered when deciding whether a patient with nonsevere OSA should be treated with CPAP or MAS.