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Continuous Positive Airway Pressure Compared with Oral Devices or Lifestyle Changes for the Treatment of Obstructive Sleep Apnea: A Review of the Clinical and Cost-effectiveness [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2014 Dec 22.

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Continuous Positive Airway Pressure Compared with Oral Devices or Lifestyle Changes for the Treatment of Obstructive Sleep Apnea: A Review of the Clinical and Cost-effectiveness [Internet].

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CONCLUSIONS AND IMPLICATIONS FOR DECISION OR POLICY MAKING

In general, limited evidence from a small number of RCTs and systematic reviews of RCTs found that in a controlled setting, CPAP lead to better efficacy than oral devices. This benefit may be offset by patient’s higher compliance to oral devices which may result in similar real life clinical effectiveness between the two methods. CPAP may be more costly than oral devices or lifestyle advice, and oral devices may be a more cost-effective option in patients who are unable to adhere to CPAP.

Matching therapy to patient’s preferences is important to determine the most appropriate treatment, which in turn will increase the chance of adherence to the treatment. A qualitative survey using focus group sessions found that patients with OSA expressed six expectations for treatment, listed in order of most to least frequently mentioned: improved health, apnea elimination, improved sleep, reduced fatigue, reduced snoring, and bed partner benefits.19 This study showed that patients may weight factors differently from practitioners in regards to the choice for OSA treatment options, and tailored intervention is needed for each individual.

Copyright © 2014 Canadian Agency for Drugs and Technologies in Health.

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Bookshelf ID: NBK349745
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