Evidence map›Paper›PMID 26163056›Full record

SynthesisSleep medicine reviews2016

Meta-analysis of randomised controlled trials of oral mandibular advancement devices and continuous positive airway pressure for obstructive sleep apnoea-hypopnoea.

Linda D Sharples, Abigail L Clutterbuck-James, Matthew J Glover, Maxine S Bennett, Rebecca Chadwick, Marcus A Pittman, Timothy G Quinnell

Open access · hybridAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Sleep medicine reviews, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 87 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
87citing papers in PubMed, 10 pooled it
13.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

87 citing papers in PubMed, 10 syntheses or guidelines pooled it, 194 citations in OpenAlex.

  1. Pooled it
  2. Efficacy of advancement treatments of the stomatognathic system on objective sleepiness in OSA: a systematic review.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025
    Pooled it
  3. Effect of norepinephrine reuptake inhibitors combined with antimuscarinic agents vs monotherapy for OSA: a systematic review and meta-analysis.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Factors influencing adherence to oral appliance therapy in adults with obstructive sleep apnea: a systematic review and meta-analysis.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021
    Pooled it
  8. Pooled it
  9. Quality Assessment of Systematic Reviews on the Efficacy of Oral Appliance Therapy for Adult and Pediatric Sleep-Disordered Breathing.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2016
    Pooled it
  10. Pooled it
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Long-term obstructive sleep apnea therapy: a 10-year follow-up of mandibular advancement device and continuous positive airway pressure.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020
    Trial
  16. Long-Term Objective Adherence to Mandibular Advancement Device Therapy Versus Continuous Positive Airway Pressure in Patients With Moderate Obstructive Sleep Apnea.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2019
    Trial
  17. Clinical- and Cost-Effectiveness of a Mandibular Advancement Device Versus Continuous Positive Airway Pressure in Moderate Obstructive Sleep Apnea.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2019
    Trial
  18. Trial
  19. Trial
  20. Article

27 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 1 country.

Linda D SharplesUniversity of Leeds Clinical Trials Research Unit, Leeds, United Kingdom; Medical Research Council Biostatistics Unit, Cambridge, United Kingdom. Electronic address: l.sharples@leeds.ac.uk.
Abigail L Clutterbuck-JamesPapworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, United Kingdom.
Matthew J GloverHealth Economics Research Unit, Brunel University, Uxbridge, Middlesex, United Kingdom.
Maxine S BennettMedical Research Council Biostatistics Unit, Cambridge, United Kingdom.
Rebecca ChadwickUniversity Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom.
Marcus A PittmanPapworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, United Kingdom.
Timothy G QuinnellPapworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, United Kingdom.
Papworth Hospital NHS Foundation Trust · GBBrunel University of London · GBMedical Research Council · GBUniversity Hospitals Coventry and Warwickshire NHS Trust · GBUniversity of Leeds · GB

Funding

Medical Research Council MC_U105232027Medical Research Council MC_UP_1302/2Medical Research Council MC_UU_00002/3
6 · The paper itself

Abstract

Obstructive sleep apnoea-hypopnoea (OSAH) causes excessive daytime sleepiness, impairs quality-of-life, and increases cardiovascular disease and road traffic accident risks. Continuous positive airway pressure (CPAP) treatment and mandibular advancement devices (MAD) have been shown to be effective in individual trials but their effectiveness particularly relative to disease severity is unclear. A MEDLINE, Embase and Science Citation Index search updating two systematic reviews to August 2013 identified 77 RCTs in adult OSAH patients comparing: MAD with conservative management (CM); MAD with CPAP; or CPAP with CM. Overall MAD and CPAP significantly improved apnoea-hypopnoea index (AHI) (MAD -9.3/hr (p < 0.001), CPAP -25.4 (p < 0.001)). In direct comparisons mean AHI and Epworth sleepiness scale score were lower (7.0/hr (p < 0.001) and 0.67 (p = 0.093) respectively) for CPAP. There were no CPAP vs. MAD trials in mild OSAH but in comparisons with CM, MAD and CPAP reduced ESS similarly (MAD 2.01 (p < 0.001); CPAP 1.23 (p = 0.012). Both MAD and CPAP are clinically effective in the treatment of OSAH. Although CPAP has a greater treatment effect, MAD is an appropriate treatment for patients who are intolerant of CPAP and may be comparable to CPAP in mild disease.

Indexed as

Cardiovascular DiseasesContinuous Positive Airway PressureHumansMandibular AdvancementRandomized Controlled Trials as TopicSleep Apnea, ObstructiveContinuous positive airway pressureMandibular advancement deviceMeta-analysisObstructive sleep apnoea-hypopnoea

Identifiers

PMID26163056
PMCPMC5378304
OpenAlexW2101091725

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.