Background

The goal of this study was to review relevant randomized controlled trials in order to determine the efficacy of continuous positive airway pressure (CPAP) versus mandibular advancement device (MAD) in the treatment of obstructive sleep apnea (OSA).

Methods

Using appropriate keywords, we identified relevant studies using PubMed, the Cochrane Library, and Embase. Key pertinent sources in the literature were also reviewed, and all articles published through October 2019 were considered for inclusion. For each study, we used odds ratios (ORs), mean difference (MD), and 95% confidence interval (95% CI) to assess and synthesize outcomes.

Results

We included 14 RCTs, for a total of 249 patients in the CPAP group and 247 in the MAD group. Compared with MAD, CPAP significantly decreased apnea hypopnea index (AHI) (WMD: −7.08, 95%CI: −9.06∼-5.10) and the percentage of stage 1 and 2 after therapy (WMD: −3.728, 95%CI: −6.912∼-0.543). However, compared with MAD, CPAP significantly decreased the SF-36-social function score (WMD: −3.381, 95%CI: −6.607∼-0.154).There was no significant difference in Epworth sleepiness scale score after therapy between the two groups.

Conclusion

CPAP has better therapeutic efficacy in OSA patients than MAD.

中文翻译：

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持续气道正压与下颌前移装置治疗阻塞性睡眠呼吸暂停：系统评价和荟萃分析。

背景

这项研究的目的是回顾相关的随机对照试验，以确定持续气道正压通气（CPAP）与下颌前移装置（MAD）在阻塞性睡眠呼吸暂停（OSA）中的疗效。

方法

使用适当的关键字，我们使用PubMed，Cochrane库和Embase识别了相关研究。还审查了文献中的关键相关来源，并考虑纳入2019年10月之前发布的所有文章。对于每项研究，我们使用比值比（OR），均值差（MD）和95％置信区间（95％CI）来评估和综合结果。

结果

我们纳入了14个RCT，CPAP组共计249例患者，MAD组共247例。与MAD相比，CPAP显着降低了呼吸暂停低通气指数（AHI）（WMD：-7.08，95％CI：-9.06〜-5.10）和治疗后1和2期的百分比（WMD：-3.728，95％CI：- 6.912〜-0.543）。然而，与MAD相比，CPAP显着降低了SF-36社交功能评分（WMD：−3.381，95％CI：−6.607〜-0.154）。两组治疗后的Epworth嗜睡量表评分无显着差异。 。

结论

CPAP对OSA患者的疗效优于MAD。