Sleep and Breathing

, Volume 17, Issue 3, pp 985–991 | Cite as

Impact of type D personality on adherence to oral appliance therapy for sleep-disordered breathing

  • M. Dieltjens
  • O. M. Vanderveken
  • D. Van den Bosch
  • K. Wouters
  • J. Denollet
  • J. A. Verbraecken
  • P. H. Van de Heyning
  • M. J. Braem
Original Article



Type D personality, defined as a combination of social inhibition and negative affectivity, has been associated with poor medication adherence and lower adherence to continuous positive airway pressure in patients with sleep-disordered breathing. Up to this date, the association of patient’s personality with adherence with a mandibular advancement device (MAD) has not been studied. The purposes of this study were to examine the association between type D personality and poor adherence to MAD treatment and to examine the impact of type D personality on perceived side effects during this treatment.


Eighty-two patients out of 113 patients with a known baseline type D scale who have started MAD treatment between June 2006 and December 2009 were included. Information about side effects and adherence were collected via a postal questionnaire. Thirty-three patients were using a monobloc MAD and 49 patients were using a duobloc MAD.


Forty-five percent of type D patients discontinued MAD treatment, whereas only 15 % of non-type D patients reported treatment discontinuation. The odds ratio for treatment discontinuation was 6.03 (95 % confidence interval 1.22–29.81; p = 0.027) for type D personality, adjusted for age, gender, MAD type (monobloc or duobloc), and decrease in apnea severity. In continuing MAD users, no significant difference in perceived side effects was reported between the personality types.


This is the first study to examine the relationship between type D personality and adherence to MAD treatment. Type D patients reported a significantly higher discontinuation rate when compared to patients without type D personality.


Compliance Mandibular advancement device treatment Obstructive sleep apnea Side effects Snoring 


Conflict of interest

All authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • M. Dieltjens
    • 1
    • 2
    • 5
  • O. M. Vanderveken
    • 2
    • 4
    • 5
  • D. Van den Bosch
    • 1
    • 2
  • K. Wouters
    • 3
  • J. Denollet
    • 6
  • J. A. Verbraecken
    • 4
    • 5
  • P. H. Van de Heyning
    • 2
    • 4
    • 5
  • M. J. Braem
    • 1
    • 5
  1. 1.Department of Special Care DentistryAntwerp University HospitalEdegemBelgium
  2. 2.Department of ENT, Head and Neck SurgeryAntwerp University HospitalEdegemBelgium
  3. 3.Department of Scientific Coordination and BiostatisticsAntwerp University HospitalEdegemBelgium
  4. 4.Multidisciplinary Sleep Disorders CentreAntwerp University HospitalEdegemBelgium
  5. 5.Faculty of Medicine and Health SciencesUniversity of AntwerpAntwerpBelgium
  6. 6.Center of Research on Psychology in Somatic diseases (CoRPS)Tilburg UniversityTilburgThe Netherlands

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