Medline ® Abstract for Reference 35
of 'Management of obstructive sleep apnea in adults'
35
TI
A randomized, controlled trial of positional therapy versus oral appliance therapy for position-dependent sleep apnea.
AU
Benoist L, de Ruiter M, de Lange J, de Vries N
SO
Sleep Med. 2017;34:109. Epub 2017 Mar 27.
OBJECTIVE:
To compare the effectiveness of positional therapy (PT) with the sleep position trainer (SPT) to oral appliance therapy (OAT) in patients with mild-to-moderate positional obstructive sleep apnea (POSA).
METHODS:
Multicenter, prospective, randomized, controlled trial. Patients with mild-to-moderate POSA (apnea-hypopnea index (AHI)≥5 ≤ 30/hour sleep) were randomized for PT or OAT. Polysomnography was repeated after 3 months. Efficacy, adherence, mean disease alleviation (MDA), quality of life, dropouts and adverse events were evaluated.
RESULTS:
A total of 177 patients were screened for the study; 99 underwent randomization and 81 completed the study. Intention-to-treat (ITT) analysis of median [IQR]AHI showed a reduction in the PT group from 13.0 [9.7-18.5]to 7.0 [3.8-12.8], p < 0.001 and in the OAT group from 11.7 [9.0-16.2]to 9.1 [4.9-11.7], p < 0.001. Mean adherence (≥4 h/night,≥5 days/week) was 89.3 ± 22.4% for SPT versus 81.3 ± 30.0% in OAT patients, p = 0.208.
CONCLUSIONS:
Oral appliance therapy and positional therapy were equally effective in reducing the median AHI in patients with mild-to-moderate POSA. The results of this study have important implications for future OSA treatment guidelines and daily clinical practice. CLINICALTRIALS.
GOV NUMBER:
NCT02045576.
AD
Department of Otorhinolaryngology Head and Neck Surgery, OLVG West, Amsterdam, The Netherlands; Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands. Electronic address: l.benoist@erasmusmc.nl.
PMID