0609 Improved Sleep Quality with Expiratory Positive Airway Pressure Enhanced Mandibular Advancement Device in OSA
Bibliographic record
Abstract
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
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".