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Sleep apnea hypopnea syndrome (SAHS) constitutes a major health problem. Continuous positive airway pressure (CPAP) is so far the treatment of choice . However, in patients with CPAP intolerance, the mandibular advancement device (MAD) is positioned as a therapeutic alternative. A descriptive study on 37 patients diagnosed with SAHS who used MAD between 2016-2018 was performed. The characteristics of the patients were evaluated, as well as the modification of the Epworth test and the polygraphic respiratory parameters with the use of MAD. A total of 37 patients were studied. The mean age was 55 years (SD 10), 28 (73.7%) males and 10 (26.3%) females. The mean body mass index (BMI) of the patients at the beginning of the study was 27.5 (SD 3.5) and the BMI at the time of the polygraph control with the MAD was 27.2 (SD 3.4), with no evidence of statistically significant differences. Regarding the Epworth test, the respiratory events and the oximeter profile, a significant improvement was observed with the use of MAD in all the evaluated parameters, except in the mean saturation (Image 1). The profile of the patients with respect to SAHS severity and its correction with the use of MAD is reflected in Image 2. Prior to the use of MAD, 27 patients presented an AHI≥15/hour and with the use of MAD, only 4 patients persisted with an AHI≥15. None of them maintained the severe degree. The change was statistically significant (p MAD is a beneficial alternative treatment in patients who reject the use of CPAP, presenting a high control of the disease.

Background: Telemonitoring might enhance continuous positive airway pressure (CPAP) adherence and save coaching time at the begining of CPAP therapy. We assessed telemonitoring (AirView Online System, ResMed) during the habituation phase of the CPAP therapy and after one year treatment in obstructive sleep apnea syndrome (OSAS). Method: 104 of 120 OSAS patients were randomised at the initiation of the treatment. The first visit was physical for the Usual care (UC, N=53) and telemonitoring groups (TM, N=50), while for TM all visits were unphysical, except at the request of the patient. Results: TM and UC groups did not differ in terms of patient characteristics (Age, gender, BMI, HAI, Epworth sleep scale and Pichot (depressive) scale). CPAP treatment did not differ (TM vs. UC) in terms of pressure treatment (11.4±2.4 vs. 11.1±2.3 cmh2o), leaks (25.5±16.1 vs 24.1±12.4 l/min), quality of sleep (ESS) (5.9±3.6 vs. 4.2±4) and depressive scale (Pichot) (2.1±3.4 vs. 2±3.7). 18 patients stopped treatment in UC and 14 in TM arm with no significant difference P=0.51, and CPAP adherence was equal in both groups p=0.57. Number of minutes coaching required per patient in the TM vs UC groups was not different 70±4min vs. 79±3min p=0.09 Conclusion: Implementation and follow-up at 1 year of CPAP for OSAS patients by TM do not modify the adherence of patients to treatment.

To assess if patients with poor adherence to CPAP have a greater anxious or depressive symptoms than those who use CPAP Retrospective observational study included patients diagnoses by home-base poligraph of SAHS in treatemnt with CPAP. Anxious depressive symptoms were evaluated using the Anxiety and Depression Hospital Scale(HADS) at diagnosis time and at 6 months after treatment with CPAP. A total of 291 patients were studied, 102 women (age 57±28.4) and 189 men (55.6 ± 28.4). The average ratio was 5.2 ± 3.8. The patients with lower use of CPAP (ratio 10 at 6 months and being the drowsiness their main symptom (average Epworth 12±8.78). In patients with a ratio of 18/8 persisted 12 and 23% at 6 months, however, it should be noted that more patients with suggestive symptoms of ADT (46%) were identified in the group of patients with a ratio> 4, although the improvement of this group was considerably greater after 6 months (HADS A/D of 38 and 31%). The subjective perception of improvement was greater in the group with a ratio> 4 (EVA 9.9 ± 3 Vs. 6.8 ± 1.5), as well as an improvement in daytime sleepines Patients with an indication for treatment with CPAP with a ratio of 11/8) that justify the poor adherence to treatment, being even more frequent in our sample the suggestive symptoms of anxiety and / or depression in those who achieve a correct use, improving the HADS A/D after 6 months of treatment.