A pilot study on comparison of subjective titration versus remotely controlled mandibular positioning during polysomnography and drug-induced sleep endoscopy, to determine the effective protrusive position for mandibular advancement device therapy.

"Declarations Ethical approvalAll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the local ethical committee at the University of Antwerp and Antwerp University Hospital. Written informed consent was obtained from all patients. Informed consentInformed consent was obtained from all individual participants included in the study. Conflict of interestAll authors have seen and approved this manuscript. MD holds a Postdoctoral Fellowship at the Research Foundation Flanders (FWO: 12H4520N). MB reports a research grant from SomnoMed at the Antwerp University Hospital. JV seats in the advisory board of ResMed, Bioprojet and MSD. MB seats in the advisory board of ResMed and SomnoMed. OMV reports research support outside the submitted work from Philips, SomnoMed, Inspire Medical Systems and Nyxoah at the Antwerp University Hospital. Consultancy for Galvani and Liva Nova, Advisory Board member for Zephyr and SomnoMed. OMV holds a Senior Clinical Investigator Fellowship from the Research Foundation Flanders (FWO: 1833517 N). The other authors report no competing interests. Conflict of interest All authors have seen and approved this manuscript. MD holds a Postdoctoral Fellowship at the Research Foundation Flanders (FWO: 12H4520N). MB reports a research grant from SomnoMed at the Antwerp University Hospital. JV seats in the advisory board of ResMed, Bioprojet and MSD. MB seats in the advisory board of ResMed and SomnoMed. OMV reports research support outside the submitted work from Philips, SomnoMed, Inspire Medical Systems and Nyxoah at the Antwerp University Hospital. Consultancy for Galvani and Liva Nova, Advisory Board member for Zephyr and SomnoMed. OMV holds a Senior Clinical Investigator Fellowship from the Research Foundation Flanders (FWO: 1833517 N). The other authors report no competing interests."

"Funding This study was part of the postdoctoral project of MD, funded by the Research Foundation Flanders (FWO, grant number 12H4520N)."

"This clinical trial was registered on Clinicaltrials.gov (NCT03716648) and approved by the local ethical committee at University of Antwerp and Antwerp University Hospital in September 2018 with protocol number 18/33/364 and Belgian Registration number: B300201837436 (protocol version July 2018 dd 08/08/2018). Written informed consent was obtained from all patients prior to the start of the study."