Evidence map›Paper›PMID 37607039›Full record

Trial reportSleep2024

Sleep apnea multi-level surgery trial: long-term observational outcomes.

Alison J Pinczel, Charmaine M Woods, Peter G Catcheside, Richard J Woodman, Andrew Simon Carney, Ching Li Chai-Coetzer, Michael Chia, Peter A Cistulli, John-Charles Hodge, Andrew Jones and 13 more

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Sleep, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 14% 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Long-Term Results of UPPP and Coblation Channeling of the Tongue for Obstructive Sleep Apnea.World journal of otorhinolaryngology - head and neck surgery · 2026
    Article
  4. Article
  5. The benefits of capturing patient-reported outcome measures for treatment of obstructive sleep apnea with hypoglossal nerve stimulation.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025
    Article
  6. Article
  7. The Repeatability of Pharyngeal Opening Pressure Under Drug-Induced Sleep Endoscopy.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2024
    Article
  8. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors at 11 institutions in 2 countries.

Alison J PinczelAdelaide Institute for Sleep Health, FHMRI Sleep Health, Flinders University, Adelaide, SA, Australia.ORCID 0000-0001-9404-6453
Charmaine M WoodsFlinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.ORCID 0000-0001-7898-9689
Peter G CatchesideAdelaide Institute for Sleep Health, FHMRI Sleep Health, Flinders University, Adelaide, SA, Australia.ORCID 0000-0002-9372-6788
Richard J WoodmanFlinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
Andrew Simon CarneyAdelaide Institute for Sleep Health, FHMRI Sleep Health, Flinders University, Adelaide, SA, Australia.ORCID 0000-0001-7507-7983
Ching Li Chai-CoetzerAdelaide Institute for Sleep Health, FHMRI Sleep Health, Flinders University, Adelaide, SA, Australia.
Michael ChiaDepartment of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia.
Peter A CistulliCharles Perkins Centre, Faculty for Medicine and Health, University of Sydney, Sydney, NSW, Australia.ORCID 0000-0002-7920-4924
John-Charles HodgeEar Nose and Throat Department, Royal Adelaide Hospital, Adelaide, SA, Australia.
Andrew JonesIllawarra Shoalhaven Local Health District, Wollongong, NSW, Australia.
Matthew E LamIllawarra ENT Head and Neck Clinic, Wollongong, NSW, Australia.
Richard LewisHead and Neck Surgery, Hollywood Medical Centre, Perth, WA, Australia.
Nigel McArdleWest Australian Sleep Disorders Research Institute, Queen Elizabeth II Medical Centre, Perth, WA, Australia.
Eng H OoiFlinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.ORCID 0000-0002-7201-815X
Siobhan Clare ReaWest Australian Sleep Disorders Research Institute, Queen Elizabeth II Medical Centre, Perth, WA, Australia.
Guy ReesENT Surgeons, Memorial Hospital, North Adelaide, SA, Australia.
Bhajan SinghWest Australian Sleep Disorders Research Institute, Queen Elizabeth II Medical Centre, Perth, WA, Australia.
Nicholas StowSydney Centre for Ear, Nose and Throat, Sydney, NSW, Australia.
Aeneas YeoDepartment of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia.
Nick AnticAdelaide Institute for Sleep Health, FHMRI Sleep Health, Flinders University, Adelaide, SA, Australia.
Ronald Doug McEvoyAdelaide Institute for Sleep Health, FHMRI Sleep Health, Flinders University, Adelaide, SA, Australia.
Edward M WeaverDepartment of Otolaryngology/Head and Neck Surgery, University of Washington, Seattle, WA, USA.
Stuart G MacKayIllawarra Shoalhaven Local Health District, Wollongong, NSW, Australia.
Flinders University · AURoyal Adelaide Hospital · AUUniversity of Wollongong · AUQueen Elizabeth II Medical Centre · AURoyal Perth Hospital · AUSir Charles Gairdner Hospital · AUSouth Australia Pathology · AUThe University of Sydney · AUThe University of Western Australia · AUUniversity of Washington · USWoolcock Institute of Medical Research · AU

Funding

Flinders FoundationFlinders UniversityNational Health and Medical Research Council 1059510Repat Foundation Prabha Seshadri Research
6 · The paper itself

Abstract

STUDY

objectivesThe sleep apnea multi-level surgery (SAMS) randomized clinical trial showed surgery improved outcomes at 6 months compared to ongoing medical management in patients with moderate or severe obstructive sleep apnea (OSA) who failed continuous positive airway pressure therapy. This study reports the long-term outcomes of the multi-level surgery as a case series.

methodsSurgical participants were reassessed >2 years postoperatively with the same outcomes reported in the main SAMS trial. Primary outcomes were apnea-hypopnea index (AHI) and Epworth sleepiness scale (ESS), with secondary outcomes including other polysomnography measures, symptoms, quality of life, and adverse events. Long-term effectiveness (baseline to long-term follow-up [LTFU]) and interval changes (6 month to LTFU) were assessed using mixed effects regression models. Control participants were also reassessed for rate of subsequent surgery and outcomes.

results36/48 (75%) of surgical participants were reevaluated (mean (standard deviation)) 3.5 (1.0) years following surgery, with 29 undergoing polysomnography. AHI was 41/h (23) at preoperative baseline and 21/h (18) at follow-up, representing persistent improvement of -24/h (95% CI -32, -17; p < 0.001). ESS was 12.3 (3.5) at baseline and 5.5 (3.9) at follow-up, representing persistent improvement of -6.8 (95% CI -8.3, -5.4; p < 0.001). Secondary outcomes were improved long term, and adverse events were minor. Interval change analysis suggests stability of outcomes. 36/43 (84%) of the control participants were reevaluated, with 25 (69%) reporting subsequent surgery, with symptom and quality of life improvements.

conclusionMulti-level upper airway surgery improves OSA burden with long-term maintenance of treatment effect in adults with moderate or severe OSA in whom conventional therapy failed. CLINICAL TRIAL: Multi-level airway surgery in patients with moderate-severe obstructive sleep apnea (OSA) who have failed medical management to assess change in OSA events and daytime sleepiness; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366019&isReview=true; ACTRN12614000338662.

Indexed as

Sleep Apnea, ObstructiveSleep Apnea SyndromesAdultContinuous Positive Airway PressureHumansPolysomnographyQuality of LifeTreatment Outcomecohort studiesfollow-up studieshumanobstructivepatient satisfactionpolysomnographysleepsleep apneasleep surgical proceduressurveys and questionnairestreatment outcome

Identifiers

PMID37607039
OpenAlexW4386070278

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.