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- Title
Oral appliance therapy vs. positional therapy for managing positional obstructive sleep apnea; a systematic review and meta-analysis of randomized control trials.
- Authors
Mohamed, Abdelrahman MA; Mohammed, Omar Magdy; Liu, Shanshan; Al-balaa, Maher; Al-warafi, Leena Ali; Peng, Song Juan; Qiao, Yi Qiang
- Abstract
Aim: To assess the efficacy of positional therapy and oral appliance therapy for the management of positional obstructive sleep apnea. Methods: We searched PubMed, Web of Science, Cochrane, and SCOPUS for relevant clinical trials. Quality assessment of the included trials was evaluated according to Cochrane's risk of bias tool. We included the following outcomes: The apnea-hypopnea index (AHI), AHI non-supine, AHI supine, sleep efficiency, percentage of supine sleep, Adherence (≥ 4 h/night, ≥ 5 days/week), Oxygen desaturation Index, Arousal Index, Epworth Sleepiness Scale score (ESS), Mean SpO2, and Functional Outcomes of Sleep Questionnaire. Results: The AHI non-supine and the ESS scores were significantly lower in the OAT cohort than in the PT cohort. The PT cohort was associated with a significantly decreased percentage of supine sleep than the OAT cohort (MD= -26.07 [-33.15, -19.00], P = 0.0001). There was no significant variation between PT cohort and OAT cohort regarding total AHI, AHI supine, ODI, sleep efficiency, arousal index, FOSQ, adherence, and mean SpO2. Conclusion: Both Positional Therapy and Oral Appliance Therapy effectively addressed Obstructive Sleep Apnea. However, Oral Appliance Therapy exhibited higher efficiency, leading to increased supine sleep percentage and more significant reductions in the Apnea Hypopnea Index during non-supine positions, as well as lower scores on the Epworth Sleepiness Scale.
- Subjects
SLEEP apnea syndrome treatment; RESEARCH funding; MANIPULATION therapy; TREATMENT effectiveness; META-analysis; DESCRIPTIVE statistics; CHI-squared test; ORTHODONTIC appliances; SYSTEMATIC reviews; MEDLINE; MEDICAL databases; POSTURE; ONLINE information services; DATA analysis software; CONFIDENCE intervals
- Publication
BMC Oral Health, 2024, Vol 24, Issue 1, p1
- ISSN
1472-6831
- Publication type
Article
- DOI
10.1186/s12903-024-04277-8