umu.sePublikationer
Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Oral Appliance Therapy in Patients With Daytime Sleepiness and Snoring or Mild to Moderate Sleep Apnea: A Randomized Clinical Trial
Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.ORCID-id: 0000-0002-9279-2791
Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Klinisk neurovetenskap.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
Visa övriga samt affilieringar
2015 (Engelska)Ingår i: JAMA Internal Medicine, ISSN 2168-6106, E-ISSN 2168-6114, Vol. 175, nr 8, s. 1278-1285Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

IMPORTANCE: Oral appliances that move the mandible forward during sleep are suggested as treatment for mild to moderate obstructive sleep apnea.

OBJECTIVE: To test whether an adjustable, custom-made oral appliance improves daytime sleepiness and quality of life in patients with daytime sleepiness and snoring or mild to moderate obstructive sleep apnea.

DESIGN, SETTING, AND PARTICIPANTS: Ninety-six patients with daytime sleepiness and an apnea-hypopnea index (AHI) lower than 30 were included in a randomized, placebo-controlled, parallel trial in Umeå, Sweden, from May 2007 through August 2011.

INTERVENTIONS: Four months' intervention with an oral appliance or a placebo device.

MAIN OUTCOMES AND MEASURES: Daytime sleepiness was measured with the Epworth Sleepiness Scale, the Karolinska Sleepiness Scale, and the Oxford Sleep Resistance (OSLER) test. Quality of life was assessed with the Short-Form 36-Item Health Survey (SF-36) and the Functional Outcomes of Sleep Questionnaire (FOSQ). Secondary outcomes included the apnea-hypopnea index, headaches, symptoms of restless legs, and insomnia.

RESULTS: Oral appliance therapy was not associated with improvements in daytime sleepiness from baseline to 4-month follow-up when compared with the placebo device; Epworth score >10: 53% at baseline to 24% at follow-up for the oral appliance group vs 54% at baseline to 40% at follow-up for the placebo device group, P = .11; median (IQR) for Karolinska score ≥7/wk: 10 (8 to 14) at baseline to 7 (4 to 9) at follow-up for the oral appliance group vs 12 (6 to 15) at baseline to 8 (5 to 12) at follow-up for the placebo device group, P = .11; mean between-group difference in OSLER test, -2.4 min (95% CI, -6.3 to 1.4). The mean between-group difference for the total FOSQ score was insignificant (-1.2 [95% CI, -2.5 to 0.1]). No domain of the SF-36 differed significantly between the groups. The AHI was below 5 in 49% of patients using the active appliance and in 11% using placebo, with an odds ratio of 7.8 (95% CI, 2.6-23.5) and a number needed to treat of 3. Snoring (P < .001) and symptoms of restless legs (P = .02) were less frequent when using the oral appliance vs placebo, but this did not apply to headache or insomnia.

CONCLUSIONS AND RELEVANCE: A custom-made, adjustable oral appliance reduces obstructive sleep apnea, snoring, and possibly restless legs without effects on daytime sleepiness and quality of life among patients with daytime sleepiness and snoring or mild to moderate sleep apnea.

TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00477009.

Ort, förlag, år, upplaga, sidor
2015. Vol. 175, nr 8, s. 1278-1285
Nationell ämneskategori
Lungmedicin och allergi
Identifikatorer
URN: urn:nbn:se:umu:diva-107198DOI: 10.1001/jamainternmed.2015.2051ISI: 000361057700007PubMedID: 26030264OAI: oai:DiVA.org:umu-107198DiVA, id: diva2:847323
Tillgänglig från: 2015-08-19 Skapad: 2015-08-19 Senast uppdaterad: 2018-06-07Bibliografiskt granskad

Open Access i DiVA

fulltext(891 kB)121 nedladdningar
Filinformation
Filnamn FULLTEXT01.pdfFilstorlek 891 kBChecksumma SHA-512
86e2a9edbcaef3dba3305d5de3dbf8934614337f449157beef75097635b1d0315b65effb47a51aed1a91651d067609bca0d7dae8a5d0cd039161005e3453404f
Typ fulltextMimetyp application/pdf

Övriga länkar

Förlagets fulltextPubMed

Personposter BETA

Marklund, MarieCarlberg, BoForsgren, LarsOlsson, TommyStenlund, HansFranklin, Karl A

Sök vidare i DiVA

Av författaren/redaktören
Marklund, MarieCarlberg, BoForsgren, LarsOlsson, TommyStenlund, HansFranklin, Karl A
Av organisationen
Institutionen för odontologiMedicinKlinisk neurovetenskapEpidemiologi och global hälsaKirurgi
I samma tidskrift
JAMA Internal Medicine
Lungmedicin och allergi

Sök vidare utanför DiVA

GoogleGoogle Scholar
Totalt: 121 nedladdningar
Antalet nedladdningar är summan av nedladdningar för alla fulltexter. Det kan inkludera t.ex tidigare versioner som nu inte längre är tillgängliga.

doi
pubmed
urn-nbn

Altmetricpoäng

doi
pubmed
urn-nbn
Totalt: 347 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf