Evidence map›Paper›PMID 34791676›Full record

ReviewClinical cardiology2021

Obstructive sleep apnea therapy for cardiovascular risk reduction-Time for a rethink?

Hasthi U Dissanayake, Juliana T Colpani, Kate Sutherland, Weiqiang Loke, Anna Mohammadieh, Yi-Hui Ou, Philip de Chazal, Peter A Cistulli, Chi-Hang Lee

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Clinical cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 3 pooled it
3.2field-weighted citation impact, top 7% 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

22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 34 citations in OpenAlex.

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  14. Observational
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  19. The role of oral appliance therapy in obstructive sleep apnoea.European respiratory review : an official journal of the European Respiratory Society · 2023
    Review
  20. 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

9 authors at 3 institutions in 2 countries.

Hasthi U DissanayakeSleep Research Group, Charles Perkins Centre & Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.
Juliana T ColpaniDepartment of Cardiology, National University Heart Centre Singapore, Singapore.
Kate SutherlandSleep Research Group, Charles Perkins Centre & Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.
Weiqiang LokeFaculty of Dentistry, National University of Singapore, Singapore.
Anna MohammadiehSleep Research Group, Charles Perkins Centre & Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.
Yi-Hui OuDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Philip de ChazalSleep Research Group, Charles Perkins Centre, Faculty of Engineering, University of Sydney, Camperdown, New South Wales, Australia.
Peter A CistulliSleep Research Group, Charles Perkins Centre & Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.
Chi-Hang LeeDepartment of Cardiology, National University Heart Centre Singapore, Singapore.ORCID https://orcid.org/0000-0001-8777-2705
The University of Sydney · AUNational University of Singapore · SGNational University Heart Centre Singapore · SG

Funding

USyd-NUS Partnership Collaboration Awards
6 · The paper itself

Abstract

Obstructive sleep apnea (OSA) is a highly prevalent and underdiagnosed medical condition, which is associated with various cardiovascular and metabolic diseases. The current mainstay of therapy is continuous positive airway pressure (CPAP); however, CPAP is known to be poorly accepted and tolerated by patients. In randomized controlled trials evaluating CPAP in cardiovascular outcomes, the average usage was less than 3.5 hours, which is below the 4 hours per night recommended to achieve a clinical benefit. This low adherence may have resulted in poor effectiveness and failure to show cardiovascular risk reduction. The mandibular advancement device (MAD) is an intraoral device designed to advance the mandible during sleep. It functions primarily through alteration of the jaw and/or tongue position, which results in improved upper airway patency and reduced upper airway collapsibility. The MAD is an approved alternative therapy that has been consistently shown to be the preferred option by patients who are affected by OSA. Although the MAD is less efficacious than CPAP in abolishing apnea and hypopnea events in some patients, its greater usage results in comparable improvements in quality-of-life and cardiovascular measures, including blood pressure reduction. This review summarizes the impact of OSA on cardiovascular health, the limitations of CPAP, and the potential of OSA treatment using MADs in cardiovascular risk reduction.

Indexed as

Cardiovascular DiseasesMandibular AdvancementSleep Apnea, ObstructiveContinuous Positive Airway PressureHumansRandomized Controlled Trials as TopicRisk FactorsTreatment Outcomeblood pressurecardiovascular riskcoronary artery diseasesleep apneaupper airway

Identifiers

PMID34791676
PMCPMC8715402
OpenAlexW3212633695

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.