الفهرس 
Introduction and backgroundOnly 14 pages are availabe for public view
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Abstract
Obstructive sleep apnea (OSA) is a condition of repetitive and intermittent closure of the upper airway (UA) during sleep. This closure occurs due to inspiratory collapse of the pharyngeal walls. Sleep quality is defined as one’s satisfaction of the sleep experience, integrating aspects of sleep initiation, sleep maintenance, sleep quantity, and refreshment upon awakening. This prospective one-group pretest-posttest quasi-experimental study carried on30 OSA patients aiming to evaluate MAD success rate in OSA patients and to estimate sleep quality improvement. This research was conducted on cases of OSA admitted to sleep center, Chest Medicine Department, Mansoura University Hospitals during the period from February 2019 to January 2021. Regarding to base line patients characteristics 30 OSA patients were included 14 male with 16 patients were female. The mean age of studied patient was 42.9 year 70. Mean of BMI of studied patients was 34.3 kg / m2 4.9 as in table (1) Mean value of AHI of studied patients was 31.4/hr15.6.Mean value of ESS was 13 6. Concerning base line AHI, there was 2 patient with mild AHI (6.7), 20 patients with moderated AHI (66.7%) and 8 patients had sever AHI (26.7%. Regarding to polysomnographic data of studied patients before and after treatment by MAD, there is very high significant improvement of AHI of studied patients whose were treated by MAD as p value <0.001and insignificant improvement as regard TST, SPT and snore episodic. Regarding to AHI response of treated patients with MAD, our study shows that 6 patients had complete response as AHI<5/hr, 22patients had partial response and 2patient with no response. Concerning sleep quality of treated patients with MAD, our study shows that significant improvement sleep quality of studied patient after treatment by MAD. This proved by significant improvement of sleep efficiency as polysmnographic parameter p value=0.009 and by highly significant improvement of Pittsburgh sleep index after treatment studied patients with MAD. Concerning sleep apnea screening questionnaire in studied patients treated with MAD, we show that significant improvement ESS after treatment studied patients with MAD. Regarding to level of upper airway obstruction in studied patients detected by CBCT and DISE, our results show that oropharyngeal collapse was the most frequent obstruction site among studied patient followed by palatal collapse. Less frequent level of obstruction was epiglottis collapse. Regarding to validity of CBCT in detection of both level and type of obstruction, our results proved that CBCT had 100% specificity and sensitivity in detection palatal and oropharyngeal collapse. CBCT had 100% specificity and 88.9% sensitivity in detection multiple level obstruction. Conclusions: We concluded that: A titratable MAD can be used with high success rate in treatment of OSA. MAD not only improve treatment of OSA but also improve sleep quality. DISE improve selection type and success of oral appliance. DISE and CBCT are comparable tools in prediction of success of MAD.