Comparative effectiveness of Mandibular advancement devices and Continuous positive airway pressure in adults with obstructive sleep Apnea: A systematic review and meta-analysis.
Abhishek Kumar Gupta, Vashi Narula, Swati Sharma et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the effectiveness of mandibular advancement devices (MADs) versus continuous positive airway pressure (CPAP) in adults with obstructive sleep apnea (OSA). Eight randomized controlled trials with 642 participants were analyzed. Results indicated that MADs had significantly higher residual apnea-hypopnea index (AHI) values compared to CPAP, with a mean difference of 11.83 events/hour, suggesting CPAP is more effective.
Key findings
- MAD therapy showed significantly higher residual AHI values compared to CPAP (MD = 11.83 events/hour).
- MADs significantly improved AHI compared to sham/control devices (MD = -15.78 events/hour).
- Secondary outcomes showed variable but generally favorable responses for MADs.
Why it matters
Understanding the comparative effectiveness of MADs and CPAP is crucial for clinicians managing OSA, particularly for patients who struggle with CPAP adherence. This information can guide treatment decisions and improve patient outcomes.
What to keep in mind
The study noted substantial heterogeneity in results, which limits the precision of the findings.