Abstract

Sleep-related breathing disorders are highly prevalent globally including in India which has led to the development of various devices to manage sleep apnea. These devices are widely used and are extensively studied by various authors. However, the data is scarce in the literature with no definitive conclusion. Aim: The present study aimed to assess the accuracy of suture patch devices used via tongue to adjustable oral devices for managing obstructive sleep apnea. Methods: The retrospective study assessed subjects with sleep apnea using either oral appliances or suture patch devices via the tongue. Before and during the therapy, polysomnography was conducted. The treatment was considered effective when AHI (apnea-hypopnea index) <5 events/hour or <10 events/hour with a resolution of sleepiness (Epworth <10). The efficacy rates were compared for removable oral appliances and suture devices via tongue to identify factors responsible for success. Results: The study assessed 402 subjects managed with removable oral appliances and 101 subjects using suture devices via the tongue. The mean AHI was 30.5±25.4. Mild, moderate, and severe OSA was seen in 34%, 29%, and 37% of study subjects respectively. OSA was reduced to <10 and <5/h in 47% of subjects with a suture patch device via tongue and 57% of subjects with adjustable oral appliances which was significantly higher with adjustable oral appliances with p=0.02. A similar statistically significant improvement in sleepiness with <10 was seen in 66% of subjects with adjustable appliances (p<0.01). Higher success was seen in subjects with less severe disease, low BMI, and young subjects. Conclusion: A suture patch device used via tongue for sleep apnea results in a lesser decrease in obstructive sleep apnea events compared to adjustable oral devices. However, a higher success is seen with suture patch devices in mild disease with less success in moderate to severe OSA and high AHI. Hence, appliance type should be selected based on AHI at baseline

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