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Article: Randomised study of three non-surgical treatments in mild to moderate obstructive sleep apnoea
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TitleRandomised study of three non-surgical treatments in mild to moderate obstructive sleep apnoea
 
AuthorsLam, B1
Sam, K1
Mok, WYW1
Cheung, MT2
Fong, DYT1
Lam, JCM1
Lam, DCL1
Yam, LYC2
Ip, MSM1
 
Issue Date2007
 
PublisherB M J Publishing Group. The Journal's web site is located at http://thorax.bmjjournals.com/
 
CitationThorax, 2007, v. 62 n. 4, p. 354-359 [How to Cite?]
DOI: http://dx.doi.org/10.1136/thx.2006.063644
 
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.
 
ISSN0040-6376
2013 Impact Factor: 8.562
 
DOIhttp://dx.doi.org/10.1136/thx.2006.063644
 
PubMed Central IDPMC2092459
 
ISI Accession Number IDWOS:000245212500015
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorLam, B
 
dc.contributor.authorSam, K
 
dc.contributor.authorMok, WYW
 
dc.contributor.authorCheung, MT
 
dc.contributor.authorFong, DYT
 
dc.contributor.authorLam, JCM
 
dc.contributor.authorLam, DCL
 
dc.contributor.authorYam, LYC
 
dc.contributor.authorIp, MSM
 
dc.date.accessioned2010-04-12T01:38:58Z
 
dc.date.available2010-04-12T01:38:58Z
 
dc.date.issued2007
 
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.
 
dc.description.naturepublished_or_final_version
 
dc.identifier.citationThorax, 2007, v. 62 n. 4, p. 354-359 [How to Cite?]
DOI: http://dx.doi.org/10.1136/thx.2006.063644
 
dc.identifier.citeulike1214936
 
dc.identifier.doihttp://dx.doi.org/10.1136/thx.2006.063644
 
dc.identifier.eissn1468-3296
 
dc.identifier.epage359
 
dc.identifier.hkuros134677
 
dc.identifier.isiWOS:000245212500015
 
dc.identifier.issn0040-6376
2013 Impact Factor: 8.562
 
dc.identifier.issue4
 
dc.identifier.openurl
 
dc.identifier.pmcidPMC2092459
 
dc.identifier.pmid17121868
 
dc.identifier.scopuseid_2-s2.0-34147222635
 
dc.identifier.spage354
 
dc.identifier.urihttp://hdl.handle.net/10722/57517
 
dc.identifier.volume62
 
dc.languageeng
 
dc.publisherB M J Publishing Group. The Journal's web site is located at http://thorax.bmjjournals.com/
 
dc.publisher.placeUnited Kingdom
 
dc.relation.ispartofThorax
 
dc.relation.referencesReferences in Scopus
 
dc.rightsThorax. Copyright © B M J Publishing Group.
 
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
 
dc.subject.meshSleep Apnea, Obstructive - therapy
 
dc.subject.meshBlood Pressure
 
dc.subject.meshContinuous Positive Airway Pressure
 
dc.subject.meshPatient Education as Topic
 
dc.subject.meshPlethysmography
 
dc.titleRandomised study of three non-surgical treatments in mild to moderate obstructive sleep apnoea
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong
  2. Pamela Youde Nethersole Eastern Hospital