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

Abstract

BACKGROUND: A systematic review and meta-analysis was performed to compare the outcomes of oral appliances (OAs) with those of CPAP in treatment of patients with obstructive sleep apnea (OSA). METHODS: Relevant studies were retrieved from the following electronic databases, up to and including September 2012: MEDLINE, PubMed, EMBASE, and Central Register of Controlled Trials. The main outcomes were Epworth Sleepiness Scale score, health-related quality of life, cognitive performance, blood pressure, apnea-hypopnea index (AHI), arousal index, minimum SpO2, percent rapid eye movement sleep, treatment usage, side effects, treatment preference, and withdrawals. RESULTS: Fourteen trials were finally included in this review. Our results demonstrated that the effects on Epworth Sleepiness Scale score (P.31 and.09 in crossover and parallel-group trials), health-related quality of life, cognitive performance, and blood pressure of OAs and CPAP were similar. Besides, pooled estimates of crossover trials suggested a significant difference in favor of CPAP regarding AHI (P