Trial reportThe European respiratory journal2025
Continuous positive airway pressure and mandibular advancement splints: the CHOICE multicentre, open-label randomised clinical trial.
Trial report in The European respiratory journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effects of mandibular advancement devices vs. CPAP on blood pressure in obstructive sleep apnea: a systematic review and meta-analysis of randomized controlled trials.Frontiers in neurologyPooled it
- Objective and subjective adherence to oral appliance therapy in adults with obstructive sleep apnea: pilot data from a one-year longitudinal study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Article
- The South Texas Oral Health Network Study of Practitioners' Approaches to Oral Appliance Therapy Titration for Obstructive Sleep Apnea and Their Impact on Patient Outcomes (PAOSA): Protocol for a Prospective Observational Study.JMIR research protocols · 2026Article
- Redefining Obstructive Sleep Apnea: Treatment in the Modern Era.Pathophysiology : the official journal of the International Society for Pathophysiology · 2026Review
- Approach to obstructive sleep apnea: Interdisciplinary considerations for optimal management.Canadian family physician Medecin de famille canadien · 2026Review
- Pharyngeal Airway Changes After Functional Orthodontic Treatment in Growing Class II Patients: A Retrospective Cephalometric Comparison of Twin Block, RPE and AMCOPLife (Basel, Switzerland) · 2025Article
- Article
- Effect of sleep apnoea interventions on multiple health outcomes: an umbrella review of meta-analyses of randomised controlled trials.EClinicalMedicine · 2025Article
- Treatment choice in mild to moderate sleep apnoea in the European Sleep Apnea Database.ERJ open research · 2025Article
- Obstructive Sleep Apnoea Treatments-Where Are We Now?Respirology (Carlton, Vic.) · 2025Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdherence to continuous positive airway pressure (CPAP) for obstructive sleep apnoea (OSA) continues to be low with high termination rates. Alternative therapies to CPAP are needed. Our objective was to compare objective adherence to CPAP and mandibular advancement splints (MAS) and to evaluate their effectiveness, and additionally to identify treatment usage patterns and the clinical effectiveness of having both therapies.
methodsThis multicentre, double-randomised, three-phase trial (titration/crossover/observation) was conducted at three Canadian universities. Eligible participants were treatment-naïve with mild-to-severe OSA. The primary outcome was objectively measured adherence (hours per night) during the crossover phase. Secondary outcomes included efficacy during the crossover phase; adherence during the observational phase; and patient-centred outcomes, blood pressure and side-effects during the crossover and observational phases. Duration of the crossover and observational phase was 2.5 and 6 months, respectively.
results81 participants were enrolled in the first randomisation. 79 entered the adaptation/titration phase (mean±sd age 52.3±10.8 years; 58 males), 73 entered the crossover phase (included in the intention-to-treat analysis) and 64 completed the observational phase. Mean objective adherence over 1 month: MAS showed higher adherence than CPAP, 6.0
conclusionsDespite the higher efficacy of CPAP and higher adherence to MAS, both demonstrate comparable clinical effectiveness on patient-centred outcomes. Having both CPAP and MAS can improve long-term management of OSA.
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