CoChat
Sign Up
Cited by 261Obstructive Sleep Apnea ResearchSleep and related disordersTemporomandibular Joint Disorders

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

Open access
Lam, B., Sam, K., Mok, W. Y., Cheung, M. T., Fong, D. Y., Lam, J. C., Lam, D. C., Yam, L. Y. +1 more·2007·Thorax
DOI 10.1136/thx.2006.063644PMC PMC2092459
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: 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.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1136/thx.2006.063644

Cites

38 of 38 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Mandibular advancement device treatment reduced sleep apnoeas compared with placebo in all studies.

    “MAD treatment reduced sleep apnoeas compared with placebo in all studies 62–66, 68–70.”

    From Non-CPAP therapies in obstructive sleep apnoea (2011) · cites this paper as [69]

    The Sleep study parameters section reports that the oral appliance group had a significant reduction in apnoea–hypopnoea index. The Discussion states that this study had no placebo-device group, so it cannot support the attributed comparison with placebo or establish the claim about all studies. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Promising effects on blood pressure, cardiac function, endothelial function, markers of oxidative stress and simulated driving performance have been reported from mandibular advancement devices.

    “Promising effects on blood pressure, cardiac function, endothelial function, markers of oxidative stress and simulated driving performance have been reported from MADs 66, 69, 84, 94–99.”

    From Non-CPAP therapies in obstructive sleep apnoea (2011) · cites this paper as [69]

    The Blood pressure section reports that morning diastolic blood pressure fell from baseline in the oral-appliance group after 10 weeks, although the change did not differ significantly between groups. Our copy does not report effects on cardiac function, endothelial function, oxidative-stress markers, or simulated driving performance; those parts of the multi-citation claim are not supported by this source. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Initial side-effects, such as jaw discomfort, tooth tenderness, excessive salivation and/or temporary occlusal changes, were reported in slightly more than half of the patients, and more frequently from mandibular advancement devices than from a control plate.

    “Initial side-effects, such as jaw discomfort, tooth tenderness, excessive salivation and/or temporary occlusal changes, were reported in slightly more than half of the patients 63, 65, 69, 71–74, 78, and more frequently from MAD than from a control plate 64.”

    From Non-CPAP therapies in obstructive sleep apnoea (2011) · cites this paper as [69]

    Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured

  • Continuous positive airway pressure reduced sleep apnoeas more efficiently or gave a higher success rate than mandibular advancement devices in all studies.

    “CPAP reduced sleep apnoeas more efficiently or gave a higher success rate in all studies 66, 69, 71–77.”

    From Non-CPAP therapies in obstructive sleep apnoea (2011) · cites this paper as [69]

  • The effect on sleepiness was usually similar between continuous positive airway pressure and mandibular advancement devices, but continuous positive airway pressure may produce a better outcome than mandibular advancement devices.

    “The effect on sleepiness was usually similar between CPAP and MADs 66, 72, 74–77, but CPAP may produce a better outcome than MAD 69, 71, 73.”

    From Non-CPAP therapies in obstructive sleep apnoea (2011) · cites this paper as [69]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Lam, B., Sam, K., Mok, W. Y., Cheung, M. T., Fong, D. Y., Lam, J. C., Lam, D. C., Yam, L. Y., & lp, M. S.
Affiliations
  • Queen Mary Hospital (CN)
  • University of Hong Kong (HK)
  • Pamela Youde Nethersole Eastern Hospital (CN)
ORCID
Venue
Thorax
Publisher
BMJ
Published
2007-01-24
Volume
62
Issue
4
Pages
354-359
ISSN
0040-6376 (ISSN-L)
DOI
10.1136/thx.2006.063644
PMC
PMC2092459
OpenAlex
W2118683528
Cited by
261
References
38
Citations by year
2026: 2 · 2025: 4 · 2024: 9 · 2023: 5 · 2022: 14 · 2021: 16 · 2020: 8 · 2019: 8 · 2018: 11 · 2017: 10 · 2016: 16 · 2015: 40 · 2014: 32 · 2013: 18 · 2012: 15
FWCI
6.41
Type
journal article
Language
en
Open access
Locations
  • Thorax (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
Keywords
obstructive sleep apnea, conservative treatment, continuous positive airway pressure, oral appliances, sleep hygiene, weight loss, health-related quality of life, daytime sleepiness, blood pressure, apnea-hypopnea index, overweight
MeSH terms
Blood Pressure, Female, Health Status, Humans, Male, Middle Aged, Patient Compliance, Patient Education as Topic, Plethysmography, Quality of Life, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review