Health Outcomes of Continuous Positive Airway Pressure versus Oral Appliance Treatment for Obstructive Sleep Apnea

Phillips, Craig L.; Grunstein, Ronald R.; Darendeliler, M. Ali; Mihailidou, Anastasia S.; Srinivasan, Vasantha K.; Yee, Brendon J.; Marks, Guy B.; Cistulli, Peter A.

doi:10.1164/rccm.201212-2223oc

Cited by 489 publications

(486 citation statements)

References 53 publications

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“…6 Compliance is better for oral appliances such as the mandibular advancement device (MAD), but the treatment efficacy is lower for oral appliances than for CPAP. [7][8][9] Surgical therapy is another therapeutic option. It can be curative without using any device during sleep.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Different Success Definitions in Non-Continuous Positive Airway Pressure Treatment for Obstructive Sleep Apnea Using Cardiopulmonary Coupling

Lee

Hong

Kim

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: The definition and the criteria for the successful treatment of obstructive sleep apnea vary, depending on the study. This study aimed to compare different success criteria of non-continuous positive airway pressure (non-CPAP) treatment for obstructive sleep apnea in terms of sleep quality by using cardiopulmonary coupling. Methods: We included 98 patients who had been treated with sleep surgery or with a mandibular advancement device at our sleep clinic from January 2011 to March 2013. The success and failure groups were divided by 6 criteria that have been used in the literature. The validity of each of the 6 criteria was evaluated by cardiopulmonary coupling-based sleep quality. Results: The parameters of cardiopulmonary coupling indicated that sleep quality improved with non-CPAP treatment: low-frequency coupling decreased from 57.4% ± 17.7% to 46.9% ± 16.5%, whereas high-frequency coupling increased from 30.2% ± 17.1% to 37.4% ± 16.7%. In multiple regression analysis, only the criterion of a reduction in the apnea-hypopnea index greater than 50% was significantly associated with sleep quality improvement (p = 0.016; 95% confidence interval, 1.008-1.076 in the high-frequency coupling increment; p = 0.001; 95% confidence interval, 1.025-1.099 in the low-frequency coupling decrement). Conclusions: Cardiopulmonary coupling analysis showed that a reduction in the apnea-hypopnea index of more than 50% might be the optimal criterion to determine the success or failure of non-CPAP treatment in terms of sleep quality. Keywords: cardiopulmonary coupling, non-continuous positive airway pressure, obstructive sleep apnea, sleep quality, success criteria Citation: Lee WH, Hong SN, Kim HJ, Rhee CS, Lee CH, Yoon IY, Kim JW. A comparison of different success definitions in non-continuous positive airway pressure treatment for obstructive sleep apnea using cardiopulmonary coupling.

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Section: Introductionmentioning

confidence: 99%

A Comparison of Different Success Definitions in Non-Continuous Positive Airway Pressure Treatment for Obstructive Sleep Apnea Using Cardiopulmonary Coupling

Lee

Hong

Kim

et al. 2016

Journal of Clinical Sleep Medicine

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“…Phillips et al [26] compared health outcomes after 1 month of CPAP and MAD therapy in patients with moderate-severe OSA. They reported that while CPAP was more efficacious than MADs in reducing the AHI, compliance was higher with MADs.…”

Section: Discussionmentioning

confidence: 99%

Biomimetic Oral Appliance Therapy in Adults with Severe Obstructive Sleep Apnea

G¹,

Griffin²

2015

J Sleep Disord Ther

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Introduction: While Continuous Positive Airway Pressure (CPAP) is widely used to manage Obstructive Sleep Apnea (OSA), compliance can be problematic in some cases. These patients are often referred for Mandibular Advancement Devices (MADs) but there is less evidence of their efficacy in severe cases. We investigated the use of biomimetic oral appliance therapy (BOAT) to test the hypothesis that severe cases of OSA can be addressed using BOAT.

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“…46 In randomized controlled trials, QoL improves after adequate treatment of OSA with positive airway pressure, 21,47 oral appliances, 48 and upper airway surgery. 49 All of these treatment modalities are commonly utilized for the treatment of OSA.…”

Section: Supporting Evidence and Rationalementioning

confidence: 99%