help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Published ahead of print on June 16, 2004, doi:10.1164/rccm.200311-1571OC

Am. J. Respir. Crit. Care Med., Volume 170, Number 6, September 2004, 656-664

A more recent version of this article appeared on September 15, 2004
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
200311-1571OCv1
170/6/656    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Barnes, M.
Right arrow Articles by Pierce, R. J
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Barnes, M.
Right arrow Articles by Pierce, R. J

Submitted on November 20, 2003
Accepted on June 15, 2004

Efficacy of Positive Airways Pressure and Oral Appliance in Mild to Moderate Obstructive Sleep Apnea

Maree Barnes1*, R. Douglas McEvoy2, Siobhan Banks2, Natalie Tarquinio3, Christopher G Murray4, Norman Vowles5, and Robert J Pierce1

1 Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia, 2 Adelaide Institute for Sleep Health, Repatriation General Hospital, Daw Park, South Australia, Australia; Department of Medicine, Flinders University of South Australia, Bedford Park, South Australia, Australia, 3 Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia, 4 Dental Department, Austin Health, Melbourne, Victoria, Australia, 5 Adelaide Institute for Sleep Health, Repatriation General Hospital, Daw Park, South Australia, Australia

* To whom correspondence should be addressed. E-mail: maree.barnes{at}austin.org.au.

The efficacy of currently-recommended treatments is uncertain in patients with mild to moderate obstructive sleep apnea (apnea-hypopnea index 5-30). A group of 114 sleep clinic patients with apnea-hypopnea index 5-30 have participated in a randomized controlled crossover trial of 3 months treatment with each of nasal continuous positive airways pressure, a mandibular advancement splint and a placebo tablet. Outcomes were sleep fragmentation and hypoxemia, daytime sleepiness, quality of life, neurobehavioral function and blood pressure. Both active treatments improved sleep outcomes, but positive airways pressure had a greater effect. Quality of life, symptoms and subjective but not objective sleepiness improved to a similar degree with both treatments, however many of the improvements seen in neuropsychological function and mood were not better than the placebo effect. Some aspects of nocturnal blood pressure were improved with the splint but not with continuous positive airways pressure. This study has shown that although both continuous positive airways pressure and mandibular advancement splint effectively treated sleep-disordered breathing and sleepiness, the expected response in neurobehavioral function was incomplete. This may be due to the splint having a lesser therapeutic effect, and continuous positive airways pressure being poorly tolerated and therefore used less in this patient group.
Key words: Sleep Apnea Obstructive, Controlled Clinical Trials Randomized, Mandibular Advancement, Positive Pressure Ventilation




This article has been cited by other articles:


Home page
 J. Dent. Res.Home page
A. Hoekema, B. Stegenga, P.J. Wijkstra, J.H. van der Hoeven, A.F. Meinesz, and L.G.M. de Bont
Obstructive Sleep apnea Therapy
J. Dent. Res., September 1, 2008; 87(9): 882 - 887.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
C. L. Phillips, B. Yee, Q. Yang, A. T. Villaneuva, J. Hedner, N. Berend, and R. Grunstein
Effects of Continuous Positive Airway Pressure Treatment and Withdrawal in Patients With Obstructive Sleep Apnea on Arterial Stiffness and Central BP
Chest, July 1, 2008; 134(1): 94 - 100.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
M. H. Sanders, J. M. Montserrat, R. Farre, and R. J. Givelber
Positive Pressure Therapy: A Perspective on Evidence-based Outcomes and Methods of Application
Proceedings of the ATS, February 15, 2008; 5(2): 161 - 172.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
T. E. Weaver and R. R. Grunstein
Adherence to Continuous Positive Airway Pressure Therapy: The Challenge to Effective Treatment
Proceedings of the ATS, February 15, 2008; 5(2): 173 - 178.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
A. S. L. Chan, R. W. W. Lee, and P. A. Cistulli
Non-Positive Airway Pressure Modalities: Mandibular Advancement Devices/Positional Therapy
Proceedings of the ATS, February 15, 2008; 5(2): 179 - 184.
[Abstract] [Full Text] [PDF]

Home page
 ERRHome page
A. Boudewyns, M. Marklund, and W. Hochban
Alternatives for OSAHS treatment: selection of patients for upper airway surgery and oral appliances
Eur. Respir. Rev., December 1, 2007; 16(106): 132 - 145.
[Abstract] [Full Text] [PDF]

Home page
 J. Dent. Res.Home page
A. Hoekema, M.H.J. Doff, L.G.M. de Bont, J.H. van der Hoeven, P.J. Wijkstra, H.R. Pasma, and B. Stegenga
Predictors of Obstructive Sleep Apnea-Hypopnea Treatment Outcome
J. Dent. Res., December 1, 2007; 86(12): 1181 - 1186.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
A. S. L. Chan, R. W. W. Lee, and P. A. Cistulli
Dental Appliance Treatment for Obstructive Sleep Apnea
Chest, August 1, 2007; 132(2): 693 - 699.
[Abstract] [Full Text] [PDF]

Home page
 HypertensionHome page
L. A. Bazzano, Z. Khan, K. Reynolds, and J. He
Effect of Nocturnal Nasal Continuous Positive Airway Pressure on Blood Pressure in Obstructive Sleep Apnea
Hypertension, August 1, 2007; 50(2): 417 - 423.
[Abstract] [Full Text] [PDF]

Home page
 Arch Intern MedHome page
P. Haentjens, A. Van Meerhaeghe, A. Moscariello, S. De Weerdt, K. Poppe, A. Dupont, and B. Velkeniers
The Impact of Continuous Positive Airway Pressure on Blood Pressure in Patients With Obstructive Sleep Apnea Syndrome: Evidence From a Meta-analysis of Placebo-Controlled Randomized Trials
Arch Intern Med, April 23, 2007; 167(8): 757 - 764.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
B. Lam, K. Sam, W. Y. Mok, M. T. Cheung, D. Y. Fong, J. C. Lam, D. C. Lam, L. Y. Yam, and M. S. lp
Randomised study of three non-surgical treatments in mild to moderate obstructive sleep apnoea
Thorax, April 1, 2007; 62(4): 354 - 359.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
S. Itzhaki, H. Dorchin, G. Clark, L. Lavie, P. Lavie, and G. Pillar
The Effects of 1-Year Treatment With a Herbst Mandibular Advancement Splint on Obstructive Sleep Apnea, Oxidative Stress, and Endothelial Function
Chest, March 1, 2007; 131(3): 740 - 749.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
D S Hui, K W To, F W Ko, J P Fok, M C Chan, J C Ngai, A H Tung, C W Ho, M W Tong, C-C Szeto, et al.
Nasal CPAP reduces systemic blood pressure in patients with obstructive sleep apnoea and mild sleepiness
Thorax, December 1, 2006; 61(12): 1083 - 1090.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
N S Marshall, M Barnes, N Travier, A J Campbell, R J Pierce, R D McEvoy, A M Neill, and P H Gander
Continuous positive airway pressure reduces daytime sleepiness in mild to moderate obstructive sleep apnoea: a meta-analysis
Thorax, May 1, 2006; 61(5): 430 - 434.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
N S Marshall, A M Neill, A J Campbell, and D S Sheppard
Randomised controlled crossover trial of humidified continuous positive airway pressure in mild obstructive sleep apnoea
Thorax, May 1, 2005; 60(5): 427 - 432.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
T. D. Bradley, Y. E. Miller, F. J. Martinez, D. C. Angus, W. MacNee, and E. Abraham
Interstitial Lung Disease, Lung Cancer, Lung Transplantation, Pulmonary Vascular Disorders, and Sleep-disordered Breathing in AJRCCM in 2004
Am. J. Respir. Crit. Care Med., April 1, 2005; 171(7): 675 - 685.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2004 American Thoracic Society 		  ATS State of the Art Course 2008