Table 2.
Traits associated with oral appliance efficacy: multiple regression
Variable | β-Value | SEM | β-SD | P Value | Interpretation |
---|---|---|---|---|---|
Constant | 47.1 | 5.1 | 1.4 | <0.0001 | |
Pharyngeal traits | |||||
VPASSIVE | −0.771 | 0.325 | −0.47 | 0.02 | Not severe and not mild collapsibility → success |
VPASSIVE2 | −0.0293 | 0.0095 | −1.1 | 0.003 | |
Compensation2 | 0.0215 | 0.0067 | 0.94 | 0.002 | Higher compensation → failure |
Compensation × arousal threshold | 0.0486 | 0.0107 | 1.4 | <0.0001 | Particularly when arousal threshold is low or response to arousal is high |
Compensation × response to arousal | −0.0171 | 0.0064 | −0.41 | 0.009 | |
Nonpharyngeal traits | |||||
Loop gain | −112 | 41 | −0.37 | 0.008 | Higher loop gain → failure |
Loop gain × compensation | −6.95 | 2.23 | −0.52 | 0.003 | Particularly when compensation or response to arousal is high |
Loop gain × response to arousal | −8.79 | 2.52 | −0.70 | 0.0008 | |
Arousal threshold | 0.420 | 0.233 | 0.32 | 0.076 | Lower arousal threshold → failure |
Arousal threshold2 | 0.0151 | 0.0055 | 0.51 | 0.007 | |
Response to arousal | −0.514 | 0.193 | −0.34 | 0.009 | Higher response to arousal → failure |
Response to arousal × VPASSIVE | −0.0212 | 0.0115 | −0.50 | 0.069 |
Definition of abbreviations: SD = standard deviation; SEM = standard error of the mean; VPASSIVE = passive collapsibility.
Oral appliance efficacy is defined as the percentage reduction in apnea–hypopnea index with treatment compared with baseline (transformed; see Methods). The table describes final results (12 of 20 terms) after backward stepwise elimination (P-to-remove = 0.157), which began with five traits, their squares, and all interaction terms. Note that the significance levels were P < 0.05 in 10 of 20 terms and P < 0.01 in 9 of 20 terms. Traits were mean subtracted before terms were generated and applied to the model (see below). β-SD describes the number of SDs of change in treatment efficacy per SD increase in each term (1.3 SD is needed to move a typical nonresponder to a typical responder). Mean values of the endotypic traits before mean substraction: VPASSIVE = 79.0 ± 20.8; loop gain = 0.43 ± 0.11; compensation = −9.5 ± 27.0%; arousal threshold = 141.8 ± 26.0%; response to arousal = 36.3 ± 22.6%. A regression model cutoff of 60% (predicted reduction in apnea–hypopnea index, untransformed) was used to define predicted responders and predicted nonresponders (maximized sensitivity plus specificity). Overall R2 = 0.30; adjusted R2 = 0.19; P = 0.003.