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Clinical Oral Investigations
Published in: Clinical Oral Investigations 7/2017

Open Access 01-09-2017 | Original Article

Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea: a randomized, placebo-controlled trial on psychological distress

Authors: Ghizlane Aarab, Maria Nikolopoulou, Jari Ahlberg, Martijn W. Heymans, Hans L. Hamburger, Jan de Lange, Frank Lobbezoo

Published in: Clinical Oral Investigations | Issue 7/2017

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Abstract

Objectives

The aim of this randomized placebo-controlled trail was to compare the effects of an objectively titrated mandibular advancement device (MAD) with those of nasal continuous positive airway pressure (nCPAP) and an intraoral placebo device on symptoms of psychological distress in OSA patients.

Materials and methods

In a parallel design, 64 mild/moderate OSA patients (52.0 ± 9.6 years) were randomly assigned to an objectively titrated MAD, nCPAP, or an intraoral placebo appliance. All patients filled out the Symptom Checklist-90-Revised twice: one before treatment and one after 6 months of treatment. The Symptom Checklist-90-Revised is a multidimensional symptom inventory designed to measure symptomatic psychological distress over the past week. Linear mixed model analyses were performed to study differences between the therapy groups for the different dimensions of the Symptom Checklist-90-Revised over time.

Results

The MAD group showed significant improvements over time in the dimensions “somatization,” “insufficiency of thinking and acting,” “agoraphobia,” “anxiety,” “sleeping problems,” and “global severity index” (F = 4.14–16.73, P = 0.048–0.000). These improvements in symptoms of psychological distress were, however, not significantly different from those observed in the nCPAP and placebo groups (P = 0.374–0.953).

Conclusion

There is no significant difference between MAD, nCPAP, and an intraoral placebo appliance in their beneficial effects on symptoms of psychological distress.

Clinical relevance

The improvement in psychological distress symptoms in mild/moderate OSA patients under MAD or nCPAP treatment may be explained by a placebo effect.
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Metadata
Title
Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea: a randomized, placebo-controlled trial on psychological distress
Authors
Ghizlane Aarab
Maria Nikolopoulou
Jari Ahlberg
Martijn W. Heymans
Hans L. Hamburger
Jan de Lange
Frank Lobbezoo
Publication date
01-09-2017
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 7/2017
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-016-2045-3

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