Graduation Date

Fall 12-15-2017

Document Type


Degree Name

Master of Science (MS)


Medical Sciences Interdepartmental Area

First Advisor

Thyagaseely Sheela Premaraj


The treatment of obstructive sleep apnea (OSA) allows for a multidisciplinary approach between dentistry and medicine. Continuous positive airway pressure (CPAP) is the gold standard for OSA treatment, but the non-adherence rates are high. The mandibular advancement device (MAD) has a higher acceptance rate than the CPAP, however the efficacy is much lower in cases of moderate to severe OSA. This thesis attempted to evaluate if there was a change in compliance when a MAD was added as a combination therapy to moderate to severe OSA subjects that were currently non-compliant with their CPAP. In addition, the change in air pressure, Epworth Sleepiness Scale (ESS) scores, Apnea-Hypopnea Index (AHI) scores, and mask leaks were examined. Combination therapy showed a statistical significant increase in compliance (+23.1%) and decrease in ESS scores (-1.4) compared to CPAP therapy alone. There was also a decrease in air pressure (-0.1846 cmH2O), AHI scores (-0.07), and mask leaks (-0.8538 leaks/min), but these decreases were not significant.