A 2021 AADSM virtual meeting abstract surveyed 150 sleep physicians about their behaviors and perspectives surrounding OAT.

By Yoona Ha

How much do sleep medicine physicians know about oral appliance therapy (OAT)? A recent survey of  150 sleep physicians, commissioned by ProSomnus Sleep Technologies and presented as an abstract at the 2021 American Academy of Dental Sleep Medicine virtual meeting, sought to answer that question.

Highlighted findings are as follows.

Perspectives on Therapies

  • For treatment of obstructive sleep apnea (OSA), sleep physicians prescribed 75% CPAP and 25% a mixture of OAT, upper airway neurostimulation, and other therapies
  • 68% reported their patients were satisfied with CPAP; 54% for implantable neurostimulation; 50% for OAT
  • 63% said that their patients successfully adopt CPAP, 54% successfully adopt OAT
  • 32% of sleep medicine physicians expected to increase OAT prescriptions over the next 3-5 years, 9% expect to decrease OAT prescriptions

Barriers to Increasing OAT prescriptions

  1. 94% cited lack of insurance coverage and reimbursement (private and Medicare)
  2. 88% cited the unpredictable, variable performance of the OAT device
  3. 88% cited side effects of OAT
  4. 86% cited lack of compliance monitoring and data
  5. 83% cited the availability of qualified sleep dentists
  6. 82% cited lengthy time to treatment with OAT
  7. 81% cited unpredictable everyday symptom alleviation
  8. 78% cited patient adherence (OAT painful, difficult to use, not reliable, break frequently)

ProSomnus CEO Len Liptak, abstract author, says the findings on adherence were surprising. “These findings indicate that sleep physicians are interested in practical factors such as side effects, inconsistent device performance or device comfort, and ease of use that may impact real-world adherence,” he says.

Liptak also highlights a lack of awareness about how these barriers to OAT adherence can be overcome easily. “For example, respondents cite lack of insurance coverage as a key barrier. Yet oral appliance therapy has been covered by private and Medicare insurance for years,” Liptak says. “Educational programs can easily address these gaps in understanding, thereby facilitating an increased utilization of OAT.”

Characteristics of Surveyed Sleep Physicians

Of the 150 sleep medicine physicians surveyed:

  • 39% practice pulmonology, 32% practice internal medicine or primary care, 15% practice neurology, and 14% are otolaryngologists.
  • 53% were not board-certified, 47% were board-certified
  • 75% were in private practice, 25% were in academic institutions
  • 327 represents the average number of OSA diagnoses made each year
  • 50% of respondents spend less than 50% of the time on sleep medicine; 11% report spending 100% of their time on sleep medicine 
  • 33% of patients are diagnosed with severe OSA, 28% moderate, 29% mild
  • 81% expressed interest in learning more about new OAT technologies and protocols

Liptak says sleep physicians’ willingness to learn more about OAT was a pervasive theme found in the study’s conclusion. “The survey, directly and indirectly, indicates an increased, future, adoption of OAT,” he says.

Yoona Ha is a freelance writer and healthcare public relations professional.


Liptak L. What do we know about sleep medicine physicians? Journal of Dental Sleep Medicine. 2021 AADSM Virtual Annual Meeting Abstracts: Abstract #12.

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