Evidence map›Paper›PMID 30927057›Full record

ArticleHeart and vessels2019

Crossover comparison between CPAP and mandibular advancement device with adherence monitor about the effects on endothelial function, blood pressure and symptoms in patients with obstructive sleep apnea.

Umpei Yamamoto, Mari Nishizaka, Hiroko Tsuda, Hiroyuki Tsutsui, Shin-Ichi Ando

Registry-linked trialAbstract readComparative StudyEquivalence Trial
PubMed Publisher
In one paragraph

Article in Heart and vessels, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05387122 (The Effect of Mandibular Advancement Devices on Markers of Cardiovascular Health in Mild to Moderate Obstructive Sleep Apnea Patients Who Are Non-Compliant With Continuous Positive Airway Pressure Therapy), which is not on this map. Cited by 15 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 8 pooled it
1.8field-weighted citation impact, top 15% 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.

NCT05387122 completednot on this mapstarted 2021, after this paper: background citation

The Effect of Mandibular Advancement Devices on Markers of Cardiovascular Health in Mild to Moderate Obstructive Sleep Apnea Patients Who Are Non-Compliant With Continuous Positive Airway Pressure Therapy

TypeobservationalSponsorUniversity of AlbertaRan2021 to 2024Enrolled4ConditionsObstructive Sleep ApneaArmsmandibular advancement device (MAD)
3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 8 syntheses or guidelines pooled it, 26 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Effectiveness of mandibular advancement devices in obstructive sleep apnea therapy for East Asian patients: a systematic review and meta-analysis.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025
    Pooled it
  4. Pooled it
  5. Pooled it
  6. European Respiratory Society guideline on non-CPAP therapies for obstructive sleep apnoea.European respiratory review : an official journal of the European Respiratory Society · 2021
    Guideline
  7. Pooled it
  8. Pooled it
  9. The treatment of mild OSA with CPAP or mandibular advancement device and the effect on blood pressure and endothelial function after one year of treatment.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021
    Trial
  10. The role of oral appliance therapy in obstructive sleep apnoea.European respiratory review : an official journal of the European Respiratory Society · 2023
    Review
  11. Treatment options in obstructive sleep apnea.Internal and emergency medicine · 2022
    Review
  12. Review
  13. Review
  14. Review
  15. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Umpei YamamotoSleep Apnea Center, Kyushu University Hospital, 3-1-1 Maidashi Higashiku, Fukuoka, Japan.
Mari NishizakaKirameki Projects Career Support Center, Kyushu University Hospital, Fukuoka, Japan.
Hiroko TsudaSleep Apnea Center, Kyushu University Hospital, 3-1-1 Maidashi Higashiku, Fukuoka, Japan.
Hiroyuki TsutsuiDepartment of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
Shin-Ichi AndoSleep Apnea Center, Kyushu University Hospital, 3-1-1 Maidashi Higashiku, Fukuoka, Japan. shinando@sleep.med.kyushu-u.ac.jp.
Kyushu University Hospital · JPKyushu University · JPSaiseikai Fukuoka General Hospital · JP

Funding

JSPS KAKENHI Grant JP17K09555
6 · The paper itself

Abstract

Mandibular advancement device (MAD) is an alternative therapeutic option for CPAP to treat obstructive sleep apnea (OSA). While MAD showed the better adherence, patients with over moderate OSA have been treated more frequently with CPAP despite increasing positive evidence on the cardiovascular outcome with MAD, even in severe patients. Thus, more information is needed regarding the cardiovascular and symptomatic outcome of MAD treatment objectively compared to CPAP. Forty-five supine-dependent OSA patients (apnea-hypopnea index 20-40/h) were randomized to either CPAP or MAD and treated for 8 weeks and switched to another for 8 weeks. The primary endpoint was improvement in the endothelial function, indexed by the flow-mediated dilatation (FMD), and the secondary endpoint was the sleep-time blood pressure (BP). The duration of MAD use was evaluated objectively by an implanted adherence monitor. Treatment efficacy was also evaluated by home sleep monitor and a questionnaire about the symptoms. The adherence was not significantly different (CPAP vs. MAD: 274.5 ± 108.9 min/night vs. 314.8 ± 127.0 min/night, p = 0.095). FMD and sleep-time mean BP were not markedly changed from the baseline with either approach (CPAP vs. MAD: FMD, + 0.47% ± 3.1% vs. + 0.85% ± 2.6%, p = 0.64; BP, - 1.5 ± 5.7 mmHg vs. - 1.2 ± 7.5 mmHg, p = 0.48), although sleepiness, nocturia, and sleep-related parameters were similarly improved and more patients preferred MAD. As MAD and CPAP showed similar effects on cardiovascular outcome and symptomatic relief even with a comparable length of usage, we might expect MAD as an alternative treatment option for CPAP in this range of OSA group.

Indexed as

Blood PressureContinuous Positive Airway PressureOcclusal SplintsAdultAgedCross-Over StudiesFemaleHumansJapanMaleMiddle AgedPatient CompliancePolysomnographyProspective StudiesSleep Apnea, ObstructiveTreatment OutcomeCPAPEndothelial functionMandibular advancement deviceObstructive sleep apnea

Identifiers

PMID30927057
OpenAlexW2929570130

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.