0649 How Aavoat (Adaptive Antero-Vertical Open Airway Therapy) Will Become the New Gold Standard for Treatment of OSA

Abstract Introduction Snorers (85%) refuse to seek care due to PAP-phobia. PAP therapy success is poor (Meta-analysis 21.44%). Gen1 precision OAT/COAT devices have gained popularity albeit severe OSA improves by 35%-50% (published studies) and over-advancement results in intolerance similar to high pressure PAP. Multi-level obstructive phenotype limits surgical success (HNS and Hyoid lift). AAVOAT delivers incremental airflow with incremental antero-vertical mandibular rotation resulting in breath-to-breath optimization of alveolar ventilation to meet oxygen demand. Methods N=250 OSA (all severities). Dental scan and AI-predictive flange/plateau customization of AIO Breathe® with RAP (2mm) and MP (4mm) was initiated. Mandibular translation of 8mm and rotation of 13 degrees, both clinically confirmed on all patients and randomly with CBCT. Clinical and HST evaluation post-treatment after two weeks of acclimatization. Results Meta-analysis of conventional therapies compared with multi-variate regression analysis of 250 cases with AAVOAT: 1. Meta PAP: 41.1% did not acquire PAP therapy after Rx. Of 58.9% who did, 72.8% maintained therapy for 3 months and dropout rate was 27.2%. Of these 72.8%, 50% showed poor compliance. Thus, successful outcome of PAP was 21.44% of patients treated. 2. Meta OAT/COAT: Recent JCSM study: OAT/COAT reduced AHI by 35-50% of all OSA. Independent OAT study reduced AHI by 75% in mild-moderate, and less than 50% in severe OSA. Compliance 75%. Overall success of 35%. 3. Meta Surgery: Hyoid suspension overall success 12%. HNS 44% patients had 68% AHI reduction, adherence 75%, overall success of HNS 22.44%. 4. N=250 AAVOAT: DX-AHIMEAN 24.2 (DX-AHIMAX 79.5), RX-AHIMEAN 2.2 (RX-AHIMAX 8), DX-LSATMEAN 83% (DX-LSATLOW 67%), P-value 0.19, adjusted R2 0.009, St. Err 0.012, t-stat 1.314, lower-95th% -0.008 and upper-95th% 0.039. Overall RX-AHI < 5 was 99.6%, compliance 96%. Overall success 95.61%. Regression Analysis forecast: RX-AHI = 1.7722 + [0.0155*(DX-AHI)]. Conclusion AAVOAT (Adaptive Antero-Vertical Open Airway Therapy) appears to be better than conventional non-invasive and surgical options for OSA. Unique AI-predictive flange/plateau design geometry successfully delivered breath-to-breath real-time demand-based optimization of airflow, irrespective of OSA severity or phenotype. AIO-AI-based approach to therapeutics can forecast successful OSA treatment with 99% accuracy. Will antero-vertical positioning and breath-to-breath adaptive airflow become the next gold standard for OSA treatment? Support (if any) AIOMEGA