Table 2.

Factors of influence on oral appliance adherence.

Factors	Decreased Adherence	Increased Adherence	No Significant Association with Adherence	Caveat
Patient and disease characteristics			Anthropometric characteristics (age, sex, obesity)
			Disease severity
			Baseline sleepiness
			Polysomnographic parameters
			Anatomical characteristics (length of the maxilla, mandible and soft palate, oropharyngeal space, crepitation at TMJ)
			Upper airway or facial skeletal abnormalities
	Desaturaters (patients with oxygen desaturations)	Arousers (patients with respiratory arousals)		Significant improvement in the ESS among the arousers
		OA therapy as the first line of treatment		Strong predictor for treatment continuation
		Complete symptom resolution		Contributes to the perception of OSA but not a strong predictor alone
Appliance fabrication and titration	Monobloc OA	Bi-Bloc OA		Relatively free mandibular movement
	Ready-made (Nontitratable) OA	Custom-made (Titratable) OA		More reported side-effects with ready-made as compared to custom-made
	Patients not using the OA for > 2 years			More likely to discontinue the treatment
		Regular dental follow-up		Helps in minimizing early side-effects which lead to early discontinuation of the treatment
Psychological and social factors	Lack of perceived benefits			Leads to early discontinuation of the treatment, consistent factor
		Support from their bed partners		Improved sleep quality of the bed partner with OA use is associated with increased adherence

ESS = Epworth Sleepiness Scale, OA = oral appliance, TMJ = temporomandibular joint.