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Socio-Economic Status: A Barrier to Access to Mandibular Advancement Device Therapy for Patients with Obstructive Sleep Apnea Syndrome in France

Author

Listed:
  • Marion Fleury
  • Marc Le Vaillant
  • Nathalie Pelletier-Fleury
  • IRSR sleep cohort group

Abstract

Background: Obstructive sleep apnea syndrome (OSAS) is a major public health problem which affects between 5 to 10% of the general population. OSAS is known to be associated with high rates of morbidity and mortality mainly due to cardiovascular diseases and traffic accidents. The burden of illness is high for the individual and society. There are 2 treatment options for OSAS, Continuous Positive Airway Pressure (CPAP) and Mandibular Advancement Device therapy (MAD). CPAP is known to be an effective but very constraining treatment. Patients are usually poorly adherent. MAD is a more recent treatment easier to use and consequently better tolerated, but MAD can only be prescribed to patients with satisfactory oral hygiene. Oral health constitutes a real issue particularly among underprivileged groups in France. Through this link, the question of whether low socio-economic status constitutes a barrier to access to care for patients with OSAS is raised. Methods and Principal Findings: In a multicenter prospective cohort of 2822 consecutive OSAS patients in whom MAD has been proposed as an alternative to CPAP between May 15, 2007 and December 1st, 2014, we identified the factors that lead to a patient diagnosed with OSAS to be treated by MAD instead of CPAP. A logistic regression was performed using a stepwise forward procedure. The main outcome of the study was that treatment by MAD was significantly associated with both educational attainment, as determined by the age at which the patient left full-time education, ≥18 years compared with

Suggested Citation

  • Marion Fleury & Marc Le Vaillant & Nathalie Pelletier-Fleury & IRSR sleep cohort group, 2015. "Socio-Economic Status: A Barrier to Access to Mandibular Advancement Device Therapy for Patients with Obstructive Sleep Apnea Syndrome in France," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-11, September.
    • Handle: RePEc:plo:pone00:0138689
    DOI: 10.1371/journal.pone.0138689
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    References listed on IDEAS

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    1. repec:dau:papers:123456789/9221 is not listed on IDEAS
    2. Frédéric Gagnadoux & Marc Le Vaillant & François Goupil & Thierry Pigeanne & Sylvaine Chollet & Philippe Masson & Marie-Pierre Humeau & Acya Bizieux-Thaminy & Nicole Meslier & the IRSR sleep cohort gr, 2011. "Influence of Marital Status and Employment Status on Long-Term Adherence with Continuous Positive Airway Pressure in Sleep Apnea Patients," PLOS ONE, Public Library of Science, vol. 6(8), pages 1-7, August.
    3. repec:dau:papers:123456789/9219 is not listed on IDEAS
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