Dental Sleep Medicine Insider November DSM Insider | Page 37

RUTH PEARSON
THE EFFICACY OF PROVENT IN LOWERING
THE APNEA HYPOPNEA INDEX
F
or patients suffering from
Obstructive Sleep Apnea (OSA),
repeated airflow restrictions
often result in blood oxyhe-
moglobin desaturation. While
oral appliances assist in nor-
malizing sleep respiration, re-
cent studies have shown that
the use of Expiratory Positive
Airway Pressure (EPAP) na-
sal devices like Provent help
reduce the apnea/hypopnea
index (AHI) even further.
A study published by the
Sleep Research Society in 2011
examined the testing of Pro-
vent on 250 subjects over a
3 month period. 127 subjects
were given Provent, and 123
subjects were given a sham
device. To participate in the
study, all of the participants
had to have a pre-testing AHI
greater than 10/hour. Hypo-
pneas were defined as reduc-
tions in airflow of 30% or more
from baseline with a duration
> 10 seconds.
After 1 week, the median AHI
value for subjects using Pro-
vent was significantly reduced
from 13.8 events/h to 5. The
AHI for the sham group in-
creased from 11.1 events/h to
11.6. At the end of the 3 month
study, the percentage de-
crease in the AHI was an im-
pressive 42.7% for the Provent
group, and 10.1% for the sham
group. For the Provent group,
the Epworth Sleepiness Scale
also decreased (9.9 ± 4.7 to 7.2
± 4.2, p < 0.0001). Impressive-
ly, the median percentage of
nights where subjects wore
the Provent device was 88.2%.
Because the original study
only lasted 3 months, a fol-
low-up study was conducted
in which the long-term effi-
cacy of Provent was studied.
After a 12 month period, the
median AHI of Provent sub-
jects was reduced from 15.7 to
4.7 events/h. The decrease in
the AHI (median) was 71.3% (p <
0.001). The median proportion
of sleep time with snoring was
reduced by 74.4% (p < 0.001),
and the Epworth Sleepiness
Scale decreased (11.1 ± 4.2 to
6.0 ± 3.2, p < 0.001). The me-
dian percentage of reported
nights used was 89.3%. The
long-term adherence to Pro-
vent was excellent.
Recent clinical trials have
therefore helped to establish
a statistically significant re-
duction in the apnea-hypo-
pnea index (AHI) that occurs
with the use of Provent. This
means that a patient is able to
sleep well rested, and enjoy a
better quality of life through-
out the day. For more infor-
mation on the use of Provent
with Oral Appliance Therapy,
visit www.sleepwellrested.
com.
RUTH PEARSON
Ruth Pearson is an attor-
ney who lives in Philadel-
phia with her family. She
has practiced in the area of
workers’ compensation for
over 20 years. As a workers’
compensation attorney, Ms.
Pearson has questioned
numerous medical profes-
sionals on the mechanism
of an injury sustained, as
well as, the best treate-
ment plan available. This
work with injured workers
has led Ms. Pearson to au-
thor a series of articles on
the use of Durable Medical
Equipment following an inju-
ry, surgery or other medical
diagnosis.