Department of Orofacial Pain and Oral Medicine, Dental Hospital, Yonsei University College of Dentistry, Seoul, Korea.
Department of Orthodontics, Institute of Craniofacial Deformities, Yonsei University College of Dentistry, Seoul, Korea.
J Sleep Res. 2022 Jun;31(3):e13508. doi: 10.1111/jsr.13508. Epub 2021 Oct 24.
Compliance with a mandibular advancement device is important for the optimal treatment of obstructive sleep apnea. Recent advances in information and communication technology-based monitoring and intervention for chronic diseases have enabled continuous monitoring and personalized management. Self-evaluation and self-regulation through objective monitoring and feedback may improve compliance. The aim of this study was to evaluate the effects of information and communication technology-based remote monitoring and feedback services, using a smartphone application, on the objective compliance with a mandibular advancement device in patients with obstructive sleep apnea. Forty individuals who were diagnosed with obstructive sleep apnea by polysomnography were randomly assigned to groups A and B. During an initial 6-week evaluation period, the mandibular advancement device-wearing time was monitored with the smartphone application in group B, but not in group A. The two groups then switched the monitoring procedures during the second 6-week period (the smartphone application was then used by group B, but not by group A). If no input data were indicated on the cloud server of the smartphone application during the monitored period, push notifications were provided twice daily. Objective compliance, monitored by a micro-recorder within the mandibular advancement device, was noted and compared based on whether the monitoring service was provided. The number of mandibular advancement device-wearing days was significantly higher in the monitored period than in the unmonitored period. The mandibular advancement device-wearing time did not differ significantly between the two groups. In conclusion, information and communication technology-based remote monitoring and feedback services demonstrated a potential to increase the objective measures of compliance with mandibular advancement devices.
对下颌前伸装置的依从性对于阻塞性睡眠呼吸暂停的最佳治疗很重要。基于信息和通信技术的慢性病监测和干预的最新进展，使得连续监测和个性化管理成为可能。通过客观监测和反馈进行自我评估和自我调节，可能会提高依从性。本研究的目的是评估基于信息和通信技术的远程监测和反馈服务（使用智能手机应用程序）对阻塞性睡眠呼吸暂停患者使用下颌前伸装置的客观依从性的影响。40 名经多导睡眠图诊断为阻塞性睡眠呼吸暂停的患者被随机分配到 A 组和 B 组。在最初的 6 周评估期内，B 组通过智能手机应用程序监测下颌前伸装置佩戴时间，但 A 组不进行监测。然后，两组在第二个 6 周的监测期内切换监测程序（B 组使用智能手机应用程序，但 A 组不使用）。如果智能手机应用程序的云服务器在监测期间没有指示输入数据，则每天提供两次推送通知。根据是否提供监测服务，通过下颌前伸装置内的微型记录器记录和比较客观依从性。与未监测期相比，监测期内下颌前伸装置佩戴天数明显增加。两组之间的下颌前伸装置佩戴时间无显著差异。总之，基于信息和通信技术的远程监测和反馈服务显示出增加下颌前伸装置依从性的客观措施的潜力。
