Title
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A randomized, controlled trial of positional therapy versus oral appliance therapy for position-dependent sleep apnea
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Author
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Abstract
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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. (C) 2017 Elsevier B.V. All rights reserved. |
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Language
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English
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Source (journal)
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Sleep medicine. - Amsterdam
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Publication
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Amsterdam
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2017
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ISSN
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1389-9457
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DOI
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10.1016/J.SLEEP.2017.01.024
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Volume/pages
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34
(2017)
, p. 109-117
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ISI
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000402353400018
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Pubmed ID
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28522078
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Full text (Publisher's DOI)
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Full text (open access)
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Full text (publisher's version - intranet only)
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