Introduction: Obstructive Sleep Apnea (OSA) is a major health problem. An adequate treatment to obtain a good control of the disease is mandatory. However, 40% of patients on CPAP treatment have poor compliance. In patients with CPAP intolerance, the mandibular advancement device (MAD) is a therapeutic alternative

The objective of this study was to assess the efficacy of MAD measured by the apnea-hypopnea index (AHI) in patients with OSA and CPAP intolerance after 3 years of follow-up

Methods: A descriptive study of patients diagnosed of OSA in the Sleep Unit of a tertiary hospital in Spain and with CPAP intolerance were analyzed between 2018 and 2022. A respiratory polygraphy was
performed at baseline, at 3 months and after 3 years

Results: 62 patients with a mean age 55± 11.6 years, 72% males were followed-up. 31 patients (50% of the initial sample) persisted with MAD after 3 years. We observed a significant decrease in the AHI both at 3 months and 3 years (p<0.005) (Figure 1). A similar improvement was observed in the oxygen desaturation index (ODI) with significant improvement at 3 months (p<0.005) and 3 years (p 0.013) (Figure 2). Daytime sleepiness measured by the Epworth scale (ESS) and change in quality of life measured by the Quebec questionnaire (QSQ), were also analyzed, with a statistically significant decrease in both at 3 months and 3 years

Conclusion: MAD is an adequate alternative therapy in patients with OSA with intolerance to CPAP, observing an adequate control of the disease in the short and long term in those patients who maintain the treatment