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Related Experiment Videos

Continuous positive airways pressure for obstructive sleep apnoea.

J White1, C Cates, J Wright

  • 1Respiratory Medicne, York District Hospital, Wigginton Rd, York, North Yorks, UK, YO31 8HE. john.white@excha.yhs-tr.northy.nhs.uk

The Cochrane Database of Systematic Reviews
|June 22, 2002
PubMed
Summary

Continuous positive airway pressure (CPAP) effectively treats obstructive sleep apnea, improving sleepiness and quality of life compared to placebo. However, patients often prefer oral appliances over CPAP, despite CPAP

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Area of Science:

  • Sleep Medicine
  • Respiratory Medicine
  • Clinical Trials

Background:

  • Obstructive sleep apnea (OSA) involves airway narrowing during sleep, leading to breathing cessation (apnea) or reduction (hypopnea).
  • OSA is associated with daytime sleepiness, premature mortality, hypertension, ischemic heart disease, stroke, and accidents.
  • Continuous positive airway pressure (CPAP) is a primary treatment for OSA.

Purpose of the Study:

  • To evaluate the efficacy of CPAP in treating adult obstructive sleep apnea.
  • To compare CPAP treatment with placebo and oral appliances.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) sourced from major databases (MEDLINE, Embase, Cinahl) and expert consultation.
  • Included 12 RCTs with 475 participants meeting criteria for OSA and an apnea/hypopnea index >5/hour.

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  • Data extraction and quality assessment were performed by two independent reviewers, with author contact for missing information.

    • Main Results:

    • CPAP significantly improved objective and subjective sleepiness, quality of life, and depression measures compared to placebo.
    • No significant effect of CPAP on daytime blood pressure was observed.
    • CPAP demonstrated superior improvement in apnea/hypopnea index and minimum oxygen saturation versus oral appliances, though patients preferred oral appliances.

    Conclusions:

    • CPAP is more effective than placebo for improving sleepiness and quality of life in OSA patients.
    • CPAP offers greater respiratory disturbance improvement than oral appliances.
    • Patient preference favors oral appliances over CPAP, despite CPAP's clinical benefits.