# A new objective titration procedure using Remotely Contactless Intelligent Sleep Monitoring System for the treatment of mandibular advancement device in OSAHS patient

## TL;DR

A new system for remotely monitoring sleep helps adjust a device for sleep apnea more quickly and conveniently.

## Contribution

A contactless sleep monitoring system enables faster and more convenient titration of mandibular advancement devices for OSAHS.

## Key findings

- RCISMS-guided titration reduced AHI by 73.7%, similar to subjective methods but in less time.
- RCISMS shortened titration time by 40.01% compared to traditional methods.
- No significant differences in symptom improvement between the two methods.

## Abstract

The key to treating Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) by mandibular advancement device (MAD) lies in determining the optimal mandibular advancement, but current subjective titration methods are time-consuming and have poor compliance. Therefore, this study proposes an objective titration scheme based on a Remotely Contactless Intelligent Sleep Monitoring System (RCISMS) to optimize the MAD titration process, improve treatment efficiency, and enhance patient comfort.

This study enrolled 60 OSAHS patients, randomly divided into a RCISMS-guided titration group (n = 30) and a subjective titration group (n = 30). Patients in the RCISMS-guided titration group used RCISMS at home to monitor AHI, which was transmitted in real-time to clinicians online for remote guidance on MAD adjustments. The subjective titration group required adjustments based on patient self-reports during clinic visits. The primary endpoint was the reduction in AHI, and secondary endpoints included titration time efficiency and improvements in subjective symptoms (Epworth Sleepiness Scale, Snoring Scale).

Both RCISMS-guided and subjective titration significantly reduced AHI (by 73.7 and 69.0%, respectively), with no significant difference in final AHI levels between the two groups (p = 0.0828). RCISMS-guided titration significantly shortened the titration cycle (27.00 ± 2.12 days vs. 45.07 ± 8.25 days, p < 0.0001), saving 40.01% of the time compared to subjective titration. There were no significant differences between the two groups in ESS reduction (RCISMS group 3.0 ± 1.2 vs. subjective titration group 3.3 ± 1.5, p = 0.3943) and Snoring VAS scores reduction (RCISMS group 3.8 ± 0.5 vs. subjective titration group 3.9 ± 0.5, p = 0.3306).

The RCISMS-guided MAD titration scheme can achieve the same therapeutic effect as traditional subjective titration methods in a shorter time, while reducing the number of patient visits, improving treatment convenience and compliance, and demonstrating significant potential for clinical application.