Trial reportCanadian respiratory journal
Higher effective oronasal versus nasal continuous positive airway pressure in obstructive sleep apnea: effect of mandibular stabilization.
Trial report in Canadian respiratory journal. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- In search of a better CPAP interface: A network meta-analysis comparing nasal masks, nasal pillows and oronasal masks.Journal of sleep research · 2022Pooled it
- Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2019Pooled it
- Impact of Mask Type on Pharyngeal Opening Pressures During Drug-Induced Sleep Endoscopy.The Laryngoscope · 2025Article
- Mechanistic insights from sleep endoscopy related to oronasal mask failures: a case report.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- Home Noninvasive Ventilation in COPD.Chest · 2024Review
- Modifications in Upper Airway Collapsibility during Sleep Endoscopy with a Mandibular Positioner: Study in Snorers and Obstructive Sleep Apnea Patients.Journal of clinical medicine · 2024Article
- The Importance of Mask Selection on Continuous Positive Airway Pressure Outcomes for Obstructive Sleep Apnea. An Official American Thoracic Society Workshop Report.Annals of the American Thoracic Society · 2020Article
- Use of the WatchPAT to detect occult residual sleep-disordered breathing in patients on CPAP for obstructive sleep apnea.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020Article
- Pressure Requirements With a Nasal Versus Oronasal Mask During a PAP Titration Study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2019Article
- Obstructive sleep apnea: in search of precision.Expert review of precision medicine and drug development · 2017Article
- Article
- Update on Oral Appliance Therapy for OSA.Current sleep medicine reports · 2017Review
- Choosing an Oronasal Mask to Deliver Continuous Positive Airway Pressure May Cause More Upper Airway Obstruction or Lead to Higher Continuous Positive Airway Pressure Requirements than a Nasal Mask in Some Patients: A Case Series.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2016Article
- Oronasal Masks Require a Higher Pressure than Nasal and Nasal Pillow Masks for the Treatment of Obstructive Sleep Apnea.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2016Article
- Body Position May Influence Oronasal CPAP Effectiveness to Treat OSA.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2016Article
- Treatment of Obstructive Sleep Apnea. Prospects for Personalized Combined Modality Therapy.Annals of the American Thoracic Society · 2016Review
- New developments in the use of positive airway pressure for obstructive sleep apnea.Journal of thoracic disease · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn some individuals with obstructive sleep apnea (OSA), oronasal continuous positive airway pressure (CPAP) leads to poorer OSA correction than nasal CPAP. The authors hypothesized that this results from posterior mandibular displacement caused by the oronasal mask.
objectiveTo test this hypothesis using a mandibular advancement device (MAD) for mandibular stabilization.
methodsSubjects whose OSA was not adequately corrected by oronasal CPAP at pressures for which nasal CPAP was effective were identified. These subjects underwent polysomnography (PSG) CPAP titration with each nasal and oronasal mask consecutively, with esophageal pressure and leak monitoring, to obtain the effective pressure (Peff) of CPAP for correcting obstructive events with each mask (maximum 20 cmH2O). PSG titration was repeated using a MAD in the neutral position. Cephalometry was performed.
resultsSix subjects with mean (± SD) nasal Peff 10.4±3.0 cmH2O were studied. Oronasal Peff was greater than nasal Peff in all subjects, with obstructive events persisting at 20 cmH2O by oronasal mask in four cases. This was not due to excessive leak. With the MAD, oronasal Peff was reduced in three subjects, and Peff <20 cmH2O could be obtained in two of the four subjects with Peff >20 cmH2O by oronasal mask alone. Subjects' cephalometric variables were similar to published norms.
conclusionIn subjects with OSA with higher oronasal than nasal Peff, this is partially explained by posterior mandibular displacement caused by the oronasal mask. Combination treatment with oronasal mask and MAD may be useful in some individuals if a nasal mask is not tolerated.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.