Dental Sleep Medicine Insider December 2015 | Page 25

AHI IS NOT THE SOLE CRITICAL DETERMINING FACTOR THAT SHOULD GUIDE TREATMENT DECISION MAKING. that even patients with severe sleep apnea actually responded equally well to oral appliance therapy, even though their AHI was reduced with less efficacy with oral appliances. They theorized that the reason for this was the result of more hours with pharyngeal support with the oral appliance. Anandam then duplicated this study. The Anandam study demonstrated again equal prevention of fatal events in patients with severe OSA with oral appliance therapy compared to CPAP. This was a well designed study which extended over an 88 month period and included over 200 patients. Anandam makes the point that an AHI can be reduced to 15 and get the reduction in cardiovascular death. He confirmed what Marin 2005, and others found. If you reduce AHI below severe, it is enough to reduce cardiac deaths. “IF S