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Related Experiment Videos

Oral appliances for obstructive sleep apnoea.

J Lim1, T J Lasserson, J Fleetham

  • 1Royal Surrey County Hospital, Guildford, Surrey, UK. jeromelim@doctors.org.uk

The Cochrane Database of Systematic Reviews
|January 27, 2006
PubMed
Summary

Oral appliances (OA) improve sleepiness and reduce breathing issues in obstructive sleep apnoea-hypopnoea (OSAH). While CPAP is more effective for breathing, OA offers a viable alternative for patients unable to tolerate CPAP.

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Area of Science:

  • Sleep Medicine
  • Respiratory Medicine
  • Otolaryngology

Background:

  • Obstructive sleep apnoea-hypopnoea (OSAH) involves recurrent upper airway obstruction during sleep.
  • Nasal continuous positive airway pressure (CPAP) is the primary treatment, but adherence can be an issue.
  • Oral appliances (OA) represent an alternative treatment option for OSAH.

Purpose of the Study:

  • To review the effectiveness of oral appliances (OA) in treating obstructive sleep apnoea-hypopnoea (OSAH) in adults.
  • To compare OA efficacy against control treatments, CPAP, and upper airway surgery.

Main Methods:

  • Systematic search of the Cochrane Airways Group Specialised Register and reference lists.
  • Inclusion of randomized trials comparing OA with control, CPAP, or surgery in adult OSAH patients.

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  • Independent data extraction and quality assessment by two authors.

    • Main Results:

    • OA reduced daytime sleepiness and improved the apnoea-hypopnoea index (AHI) compared to control appliances.
    • CPAP was more effective than OA in reducing AHI and improving nocturnal oxygen saturation.
    • No significant difference in symptom scores between OA and CPAP was observed; some patients preferred OA.

    Conclusions:

    • OA shows promise in improving subjective sleepiness and sleep-disordered breathing compared to no treatment.
    • CPAP demonstrates greater efficacy in improving objective sleep-disordered breathing measures than OA.
    • OA is a suitable recommendation for mild symptomatic OSAH or for patients intolerant to CPAP.