Comparing Treatment Effectiveness and Patient-Reported Outcome Measures of Four Treatment Options for Obstructive...

Area of Science:

• Sleep Medicine
• Otolaryngology
• Respiratory Medicine

Background:

• Obstructive sleep apnea (OSA) is a common condition affecting millions worldwide.
• Current treatments include Continuous Positive Airway Pressure (CPAP), Mandibular Advancement Devices (MAD), Upper Airway Stimulation (UAS), and Maxillomandibular Advancement (MMA).
• Direct comparative studies on the efficacy of these four OSA interventions are lacking in current literature.

Purpose of the Study:

• To compare the efficacy of four common obstructive sleep apnea (OSA) treatments: CPAP, MAD, UAS, and MMA.
• To evaluate therapeutic response using mean disease alleviation, a measure of post-treatment apnea-hypopnea index (AHI) adjusted for compliance.
• To assess secondary outcomes including remaining AHI and patient-reported outcome measures.

Main Methods:

• A retrospective cohort study of 119 OSA patients treated between January 2018 and December 2020.
• Patients received CPAP, MAD, UAS, or MMA, with treatment selection based on OSA severity.
• Efficacy was measured by mean disease alleviation, with multivariate statistical analyses performed.

Main Results:

• Maxillomandibular advancement (MMA) showed the highest mean disease alleviation (36.08%), followed by UAS (22.88%), MAD (6.80%), and CPAP (5.00%).
• The differences in efficacy between the four treatments were statistically significant (P < .001).
• MMA and UAS demonstrated significantly greater effectiveness compared to CPAP and MAD.

Conclusions:

• Surgical interventions (MMA and UAS) are significantly more effective in treating OSA than non-surgical options (CPAP and MAD).
• These findings suggest that surgical alternatives may be considered earlier in treatment guidelines, especially for patients with severe OSA.
• Optimizing OSA treatment strategies may involve earlier consideration of surgical interventions for improved patient outcomes.