Evidence map›Paper›PMID 32003735›Full record

Trial reportJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2020

Efficacy of a novel oral appliance and the role of posture on nasal resistance in obstructive sleep apnea.

Benjamin K Tong, Carolin Tran, Andrea Ricciardiello, Alan Chiang, Michelle Donegan, Nick Murray, Irene Szollosi, Jason Amatoury, Jayne C Carberry, Danny J Eckert

Open access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.6field-weighted citation impact, top 17% 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

6 citing papers in PubMed, 19 citations in OpenAlex.

  1. Trial
  2. Article
  3. Review
  4. Article
  5. Analysis of nasal resistance regulation mechanism during postural changes in patients with obstructive sleep apnea by measuring heart rate variability.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023
    Article
  6. Article
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

10 authors at 5 institutions in 2 countries.

Benjamin K TongNeuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.
Carolin TranNeuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.
Andrea RicciardielloNeuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.
Alan ChiangNeuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.
Michelle DoneganNeuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.
Nick MurrayPrince of Wales Hospital, Sydney, New South Wales, Australia.
Irene SzollosiThe Prince Charles Hospital, Brisbane, Queensland, Australia.
Jason AmatouryNeuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.
Jayne C CarberryNeuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.
Danny J EckertNeuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.
Neuroscience Research Australia · AUAdelaide Institute for Sleep Health · AUUNSW Sydney · AUPrince Charles Hospital · AUPrince of Wales Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

objectivesHigh nasal resistance is associated with oral appliance treatment failure in obstructive sleep apnea (OSA). A novel oral appliance with a built-in oral airway has been shown to reduce pharyngeal pressure swings during sleep and may be efficacious in those with high nasal resistance. The role of posture and mandibular advancement on nasal resistance in OSA remains unclear. This study aimed to determine (1) the effects of posture and mandibular advancement on nasal resistance in OSA and (2) the efficacy of a new oral appliance device including in patients with high nasal resistance.

methodsA total of 39 people with OSA (7 females, apnea-hypopnea index (AHI) (mean ± standard deviation) = 29 ± 21 events/h) completed split-night polysomnography with and without oral appliance (order randomized). Prior to sleep, participants were instrumented with a nasal mask, pneumotachograph, and a choanal pressure catheter for gold standard nasal resistance quantification seated, supine and lateral (with and without oral appliance, order randomized).

resultsAwake nasal resistance increased from seated, to supine, to lateral posture (median [interquartile range] = 1.8 [1.4, 2.7], 2.7 [1.7, 3.5], 3.4 [1.9, 4.6] cm H₂O/L/s, P < .001). Corresponding measures of nasal resistance did not change with mandibular advancement (2.3 [1.4, 3.5], 2.5 [1.8, 3.6], 3.5 [1.9, 4.8] cm H₂O/L/s, P = .388). The median AHI reduced by 47% with oral appliance therapy (29 ± 21 versus 18 ± 15 events/h, P = .002). Participants with high nasal resistance (> 3 cm H₂O/L/s) had similar reductions in AHI versus those with normal nasal resistance (61 [-8, 82] versus 40 [-5, 62] %, P = .244).

conclusionsNasal resistance changes with posture in people with OSA. A novel oral appliance with a built-in oral airway reduces OSA severity in people with OSA, including in those with high nasal resistance. CLINICAL

trial registrationRegistry: ANZCTR; Title: Combination therapy for obstructive sleep apnoea; Identifier: ACTRN12617000492358; URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372279.

Indexed as

Mandibular AdvancementSleep Apnea, ObstructiveContinuous Positive Airway PressureFemaleHumansPolysomnographyPostureTreatment Outcomelungmandibular advancement therapysleep-disordered breathingupper airway physiology

Identifiers

PMID32003735
PMCPMC7161450
OpenAlexW3003196203

What OpenQuestion holds

Textmetadata
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.