title: Impact of type D personality on adherence to oral appliance therapy for sleep-disordered breathing.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Special Care Dentistry, Antwerp University Hospital, Edegem, Belgium. Marijke.Dieltjens@uza.be
authors.forename: M
authors.initials: M
authors.lastname: Dieltjens
authors.forename: O M
authors.initials: OM
authors.lastname: Vanderveken
authors.forename: D
authors.initials: D
authors.lastname: Van den Bosch
authors.forename: K
authors.initials: K
authors.lastname: Wouters
authors.forename: J
authors.initials: J
authors.lastname: Denollet
authors.forename: J A
authors.initials: JA
authors.lastname: Verbraecken
authors.forename: P H
authors.initials: PH
authors.lastname: Van de Heyning
authors.forename: M J
authors.initials: MJ
authors.lastname: Braem
mesh_terms: D000328:Adult; D001530:Belgium; D005260:Female; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000295:instrumentation* / Q000523:psychology*; D008875:Middle Aged; D017090:Occlusal Splints; D010349:Patient Compliance / Q000523:psychology*; D010352:Patient Dropouts / Q000523:psychology; D017286:Polysomnography; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000523:psychology* / Q000628:therapy*; D064415:Type D Personality