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Article: Randomised study of three non-surgical treatments in mild to moderate obstructive sleep apnoea

TitleRandomised study of three non-surgical treatments in mild to moderate obstructive sleep apnoea
Authors
Issue Date2007
PublisherB M J Publishing Group. The Journal's web site is located at http://thorax.bmjjournals.com/
Citation
Thorax, 2007, v. 62 n. 4, p. 354-359 How to Cite?
AbstractBackground: Patients with mild to moderate obstructive sleep apnoea (OSA) may be managed with different treatment options. This study compared the effectiveness of three commonly used non-surgical treatment modalities. Methods: Subjects with mild to moderate OSA were randomised to one of three treatment groups for 10 weeks: conservative measures (sleep hygiene) only, continuous positive airways pressure (CPAP) in addition to conservative measures or an oral appliance in addition to conservative measures. All overweight subjects were referred to a weight-reduction class. OSA was assessed by polysomnography. Blood pressure was recorded in the morning and evening in the sleep laboratory. Daytime sleepiness was assessed with the Epworth Sleepiness Scale. Health-related quality of life (HRQOL) was assessed with the 36-Item Short-Form Health Survey (SF-36) and Sleep Apnoea Quality of Life Index (SAQLI). Results: 101 subjects with a mean (SEM) apnoea-hypopnoea index (AHI) of 21.4 (1.1) were randomised to one of the three groups. The severity of sleep-disordered breathing was decreased in the CPAP and oral appliance groups compared with the conservative measures group, and the CPAP group was significantly better than the oral appliance group. Relief from sleepiness was significantly better in the CPAP group. CPAP was also better than the oral appliance or conservative measures in improving the "bodily pain" domain, and better than conservative measures in improving the "physical function" domain of SF-36. Both CPAP and the oral appliance were more effective than conservative measures in improving the SAQLI, although no difference was detected between the CPAP and oral appliance groups. CPAP and the oral appliance significantly lowered the morning diastolic blood pressure compared with baseline values, but there was no difference in the changes in blood pressure between the groups. There was also a linear relationship between the changes in AHI and body weight. Conclusion: CPAP produced the best improvement in terms of physiological, symptomatic and HRQOL measures, while the oral appliance was slightly less effective. Weight loss, if achieved, resulted in an improvement in sleep parameters, but weight control alone was not uniformly effective.
Persistent Identifierhttp://hdl.handle.net/10722/57517
ISSN
2014 Impact Factor: 8.290
2014 SCImago Journal Rankings: 3.142
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLam, Ben_HK
dc.contributor.authorSam, Ken_HK
dc.contributor.authorMok, WYWen_HK
dc.contributor.authorCheung, MTen_HK
dc.contributor.authorFong, DYTen_HK
dc.contributor.authorLam, JCMen_HK
dc.contributor.authorLam, DCLen_HK
dc.contributor.authorYam, LYCen_HK
dc.contributor.authorIp, MSMen_HK
dc.date.accessioned2010-04-12T01:38:58Z-
dc.date.available2010-04-12T01:38:58Z-
dc.date.issued2007en_HK
dc.identifier.citationThorax, 2007, v. 62 n. 4, p. 354-359en_HK
dc.identifier.issn0040-6376en_HK
dc.identifier.urihttp://hdl.handle.net/10722/57517-
dc.description.abstractBackground: Patients with mild to moderate obstructive sleep apnoea (OSA) may be managed with different treatment options. This study compared the effectiveness of three commonly used non-surgical treatment modalities. Methods: Subjects with mild to moderate OSA were randomised to one of three treatment groups for 10 weeks: conservative measures (sleep hygiene) only, continuous positive airways pressure (CPAP) in addition to conservative measures or an oral appliance in addition to conservative measures. All overweight subjects were referred to a weight-reduction class. OSA was assessed by polysomnography. Blood pressure was recorded in the morning and evening in the sleep laboratory. Daytime sleepiness was assessed with the Epworth Sleepiness Scale. Health-related quality of life (HRQOL) was assessed with the 36-Item Short-Form Health Survey (SF-36) and Sleep Apnoea Quality of Life Index (SAQLI). Results: 101 subjects with a mean (SEM) apnoea-hypopnoea index (AHI) of 21.4 (1.1) were randomised to one of the three groups. The severity of sleep-disordered breathing was decreased in the CPAP and oral appliance groups compared with the conservative measures group, and the CPAP group was significantly better than the oral appliance group. Relief from sleepiness was significantly better in the CPAP group. CPAP was also better than the oral appliance or conservative measures in improving the "bodily pain" domain, and better than conservative measures in improving the "physical function" domain of SF-36. Both CPAP and the oral appliance were more effective than conservative measures in improving the SAQLI, although no difference was detected between the CPAP and oral appliance groups. CPAP and the oral appliance significantly lowered the morning diastolic blood pressure compared with baseline values, but there was no difference in the changes in blood pressure between the groups. There was also a linear relationship between the changes in AHI and body weight. Conclusion: CPAP produced the best improvement in terms of physiological, symptomatic and HRQOL measures, while the oral appliance was slightly less effective. Weight loss, if achieved, resulted in an improvement in sleep parameters, but weight control alone was not uniformly effective.en_HK
dc.languageengen_HK
dc.publisherB M J Publishing Group. The Journal's web site is located at http://thorax.bmjjournals.com/en_HK
dc.relation.ispartofThoraxen_HK
dc.rightsThorax. Copyright © B M J Publishing Group.en_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshSleep Apnea, Obstructive - therapyen_HK
dc.subject.meshBlood Pressureen_HK
dc.subject.meshContinuous Positive Airway Pressureen_HK
dc.subject.meshPatient Education as Topicen_HK
dc.subject.meshPlethysmographyen_HK
dc.titleRandomised study of three non-surgical treatments in mild to moderate obstructive sleep apnoeaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0040-6376&volume=62&issue=4&spage=354&epage=359&date=2007&atitle=Randomised+study+of+three+non-surgical+treatments+in+mild+to+moderate+obstructive+sleep+apnoeaen_HK
dc.identifier.emailFong, DYT: dytfong@hku.hken_HK
dc.identifier.emailLam, DCL: dcllam@hku.hken_HK
dc.identifier.emailIp, MSM: msmip@hku.hken_HK
dc.identifier.authorityFong, DYT=rp00253en_HK
dc.identifier.authorityLam, DCL=rp01345en_HK
dc.identifier.authorityIp, MSM=rp00347en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1136/thx.2006.063644en_HK
dc.identifier.pmid17121868en_HK
dc.identifier.pmcidPMC2092459-
dc.identifier.scopuseid_2-s2.0-34147222635en_HK
dc.identifier.hkuros134677-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34147222635&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume62en_HK
dc.identifier.issue4en_HK
dc.identifier.spage354en_HK
dc.identifier.epage359en_HK
dc.identifier.eissn1468-3296-
dc.identifier.isiWOS:000245212500015-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridLam, B=9246012800en_HK
dc.identifier.scopusauthoridSam, K=6603582227en_HK
dc.identifier.scopusauthoridMok, WYW=7005237943en_HK
dc.identifier.scopusauthoridCheung, MT=7201897513en_HK
dc.identifier.scopusauthoridFong, DYT=35261710300en_HK
dc.identifier.scopusauthoridLam, JCM=25923453500en_HK
dc.identifier.scopusauthoridLam, DCL=7201749615en_HK
dc.identifier.scopusauthoridYam, LYC=7102764741en_HK
dc.identifier.scopusauthoridIp, MSM=7102423259en_HK
dc.identifier.citeulike1214936-

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