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Type: Journal article
Title: Efficacy of positive airway pressure and oral appliance in mild to moderate obstructive sleep apnea
Author: Barnes, M.
McEvoy, R.
Banks, S.
Tarquinio, N.
Murray, C.
Vowles, N.
Pierce, R.
Citation: American Journal of Respiratory and Critical Care Medicine, 2004; 170(6):656-664
Publisher: American Thoracic Society
Issue Date: 2004
ISSN: 1073-449X
Statement of
Maree Barnes, R. Douglas McEvoy, Siobhan Banks, Natalie Tarquinio, Christopher G. Murray, Norman Vowles and Robert J. Pierce
Abstract: The efficacy of currently recommended treatments is uncertain in patients with mild to moderate obstructive sleep apnea (apnea-hypopnea index [AHI], 5-30). A group of 114 sleep clinic patients with an AHI of 5-30 have participated in a randomized controlled crossover trial of 3 months of treatment with each of nasal continuous positive airway pressure (CPAP), a mandibular advancement splint, and a placebo tablet. Outcomes were sleep fragmentation and hypoxemia, daytime sleepiness, quality of life, neurobehavioral function, and blood pressure. Both active treatments improved sleep outcomes, but positive airway pressure had a greater effect. The quality of life, symptoms, and subjective but not objective sleepiness improved to a similar degree with both treatments; however, many of the improvements seen in neuropsychologic function and mood were not better than the placebo effect. Some aspects of nocturnal blood pressure were improved with the splint but not with CPAP. This study has shown that although both CPAP and mandibular advancement splint effectively treated sleep-disordered breathing and sleepiness, the expected response in neurobehavioral function was incomplete. This may be due to the splint having a lesser therapeutic effect and CPAP being poorly tolerated and therefore used less in this patient group.
Keywords: Humans
Sleep Apnea, Obstructive
Treatment Outcome
Continuous Positive Airway Pressure
Mandibular Advancement
Cross-Over Studies
Orthodontic Appliances, Removable
Quality of Life
Middle Aged
DOI: 10.1164/rccm.200311-1571OC
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