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Research ArticleOriginal Research

The comparison of CPAP and OA in treatment of patients with OSA: A systematic review and meta-analysis

Wenyang Li, Lin Xiao and Jing Hu
Respiratory Care January 2013, respcare.02245; DOI: https://doi.org/10.4187/respcare.02245
Wenyang Li
1State Key Laboratory of Oral Diseases and Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Lin Xiao
2Department of Oral & Maxillofacial Surgery, Central Hospital of Fuling, Gaoshengtang Road 2#, Fuling, Chongqing, China
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Jing Hu
1State Key Laboratory of Oral Diseases and Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, Chengdu, Sichuan, China
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  • For correspondence: [email protected]
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Abstract

Background: A systematic review and meta-analysis was performed to compare the outcomes of oral appliances (OA) with those of continuous positive airway pressure (CPAP) in treatment of patients with obstructive sleep apnea (OSA).

Methods: Relevant studies were retrieved from the following electronic databases up to and including Semptember 2012: MEDLINE, PubMed, EMBASE, and Central Register of Controlled Trials. Main outcomes were epworth sleepiness scale (ESS), health-related quality of life, cognitive performance, blood pressure, apnoea and hypopnoea index (AHI), arousal Index (AI), minimum saturation (Min SaO2), rapid eye movement sleep, % (REM%), treatment usage, side effects, treatment preference and withdrawals.

Results: Fourteen trials were finally included in this review. Our results demonstrated that the effects on ESS (p=0.31 and 0.09 in cross-over and parallel-group trials), health-related quality of life, cognitive performance, and blood pressure of OA and CPAP were similar. Besides, pooled estimates of cross-over trials suggested a significant difference in favor of CPAP regarding AHI (p<0.00001), AI (p=0.001), and Min SaO2 (p<0.00001), while pooled estimates of parallel-group trials showed a significant difference in favor of CPAP regarding AHI (p<0.00001) and REM% (p=0.02). Moreover, OA and CPAP yielded fairly similar results in terms of treatment usage (p=0.26, hours/night in cross-over trials and p=0.14, hours/night; p=0.19, nights/week in parallel-group trials), treatment preference, side effects and withdrawals (p=0.34 in parallel- group trials).

Conclusions: CPAP yielded better PSG outcomes especially in reducing AHI than OA, indicating that OA was less effective than CPAP in improving sleep disordered breathing. However, similar results from OA and CPAP in terms of clinical and other related outcomes were found, suggesting that it would appear proper to offer OA to patients who are unable or unwilling to persist with CPAP.

  • Oral appliances
  • Continuous positive airway pressure
  • Obstructive sleep apnea
  • Meta-analysis

Footnotes

  • ↵*Correspondence: Jing Hu, PhD, State Key Laboratory of Oral Diseases and Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, 17#, third segment, Renmin South Road, Chengdu, Sichuan 610041, China. Telephone: +86-28-85502334, fax number: +86-28-85502334, e-mail: hujing136{at}sohu.com.
  • Copyright © 2012 by Daedalus Enterprises Inc.
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Respiratory Care: 68 (4)
Respiratory Care
Vol. 68, Issue 4
1 Apr 2023
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The comparison of CPAP and OA in treatment of patients with OSA: A systematic review and meta-analysis
Wenyang Li, Lin Xiao, Jing Hu
Respiratory Care Jan 2013, respcare.02245; DOI: 10.4187/respcare.02245

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The comparison of CPAP and OA in treatment of patients with OSA: A systematic review and meta-analysis
Wenyang Li, Lin Xiao, Jing Hu
Respiratory Care Jan 2013, respcare.02245; DOI: 10.4187/respcare.02245
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Keywords

  • oral appliances
  • continuous positive airway pressure
  • obstructive sleep apnea
  • meta-analysis

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