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Erschienen in: Sleep and Breathing 3/2022

13.09.2021 | Sleep Breathing Physiology and Disorders • Review

Impact of oral appliance therapy on quality of life (QoL) in patients with obstructive sleep apnea — a systematic review and meta-analysis

verfasst von: Hita Rangarajan, Sridevi Padmanabhan, Sukanya Ranganathan, Vignesh Kailasam

Erschienen in: Sleep and Breathing | Ausgabe 3/2022

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Abstract

Purpose

Treatment of patients with obstructive sleep apnea (OSA) using mandibular advancement appliances enhances the airway and may be an alternative to continuous positive airway pressure (CPAP) in individuals with reduced adherence to CPAP therapy. The effectiveness as well as improved patient compliance associated with these appliances may improve the quality of life in patients with OSA. The aim of this systematic review of studies was to determine the improvement in quality of life amongst patients with OSA who were treated with an oral appliance.

Methods

The research study was registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42021193386). A search was carried out using the search engines Google Scholar, PubMed, Ovid, Cochrane Trial Registry, and LILACS. Patients with OSA treated with oral appliance therapy to advance the mandible were studied. Twenty-five studies were identified through the literature search and all had varying control groups for assessment of quality of life. Seventeen studies were included for the quantitative synthesis.

Results

QoL, evaluated by the Functional Outcomes of Sleep Questionnaire (FOSQ), significantly improved in patients treated with oral appliance therapy. There was a mean difference of 1.8 points between the baseline scores and the scores following treatment with an oral appliance.

Conclusion

Overall, a significant improvement in the QoL was observed with the Functional Outcomes of Sleep Questionnaire, following oral appliance therapy.
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Literatur
1.
Zurück zum Zitat Vanarsdall RL (1994) Orthodontics: current principles and techniques. CV Mosby Vanarsdall RL (1994) Orthodontics: current principles and techniques. CV Mosby
2.
Zurück zum Zitat White DP, Younes MK (2012) Obstructive sleep apnoea, Comprehensive Physiology White DP, Younes MK (2012) Obstructive sleep apnoea, Comprehensive Physiology
3.
Zurück zum Zitat Garvey JF, Pengo MF, Drakatos P, Kent BD (2015) Epidemiological aspects of obstructive sleep apnea. J Thorac Dis 7(5):920–929PubMedPubMedCentral Garvey JF, Pengo MF, Drakatos P, Kent BD (2015) Epidemiological aspects of obstructive sleep apnea. J Thorac Dis 7(5):920–929PubMedPubMedCentral
4.
Zurück zum Zitat Attanasio R, Bailey DR (2009) Dental management of sleep disorders. John Wiley & Sons Attanasio R, Bailey DR (2009) Dental management of sleep disorders. John Wiley & Sons
5.
Zurück zum Zitat Rangarajan V (2019) Sleep-related disorders and its relevance in dental practice. Journal of Interdisciplinary Dentistry 9(2):49CrossRef Rangarajan V (2019) Sleep-related disorders and its relevance in dental practice. Journal of Interdisciplinary Dentistry 9(2):49CrossRef
6.
Zurück zum Zitat Behrents RG, Shelgikar AV, Conley RS, Flores-Mir C, Hans M, Levine M, ..., Hittner J (2019). Obstructive sleep apnea and orthodontics: an American Association of Orthodontists White Paper. American Journal of Orthodontics and Dentofacial Orthopedics, 156(1), 13-28 Behrents RG, Shelgikar AV, Conley RS, Flores-Mir C, Hans M, Levine M, ..., Hittner J (2019). Obstructive sleep apnea and orthodontics: an American Association of Orthodontists White Paper. American Journal of Orthodontics and Dentofacial Orthopedics, 156(1), 13-28
7.
Zurück zum Zitat Schwartz M, Acosta L, Hung YL, Padilla M, Enciso R (2018) Effects of CPAP and mandibular advancement device treatment in obstructive sleep apnea patients: a systematic review and meta-analysis. Sleep and Breathing 22(3):555–568CrossRef Schwartz M, Acosta L, Hung YL, Padilla M, Enciso R (2018) Effects of CPAP and mandibular advancement device treatment in obstructive sleep apnea patients: a systematic review and meta-analysis. Sleep and Breathing 22(3):555–568CrossRef
8.
Zurück zum Zitat Ferguson KA, Ono T, Lowe AA, Al-Majed S, Love LL, Fleetham JA (1997) A short-term controlled trial of an adjustable oral appliance for the treatment of mild to moderate obstructive sleep apnoea. Thorax 52(4):362–368CrossRef Ferguson KA, Ono T, Lowe AA, Al-Majed S, Love LL, Fleetham JA (1997) A short-term controlled trial of an adjustable oral appliance for the treatment of mild to moderate obstructive sleep apnoea. Thorax 52(4):362–368CrossRef
9.
Zurück zum Zitat Johnston CD, Gleadhill IC, Cinnamond MJ, Gabbey J, Burden DJ (2002) Mandibular advancement appliances and obstructive sleep apnoea: a randomized clinical trial. The European Journal of Orthodontics 24(3):251–262CrossRef Johnston CD, Gleadhill IC, Cinnamond MJ, Gabbey J, Burden DJ (2002) Mandibular advancement appliances and obstructive sleep apnoea: a randomized clinical trial. The European Journal of Orthodontics 24(3):251–262CrossRef
10.
Zurück zum Zitat Cunningham SJ, O’Brien C (2007) Quality of life and orthodontics. In Seminars in Orthodontics (Vol. 13, No. 2, pp. 96–103). WB Saunders Cunningham SJ, O’Brien C (2007) Quality of life and orthodontics. In Seminars in Orthodontics (Vol. 13, No. 2, pp. 96–103). WB Saunders
11.
Zurück zum Zitat World Health Organization. The world health organization quality of life (WHOQOL)-BREF. No. WHO/HIS/HSI Rev. 2012.02. World Health Organization, 2004 World Health Organization. The world health organization quality of life (WHOQOL)-BREF. No. WHO/HIS/HSI Rev. 2012.02. World Health Organization, 2004
12.
Zurück zum Zitat Moyer CA, Sonnad SS, Garetz SL, Helman JI, Chervin RD (2001) Quality of life in obstructive sleep apnea: a systematic review of the literature. Sleep Med 2(6):477–491CrossRef Moyer CA, Sonnad SS, Garetz SL, Helman JI, Chervin RD (2001) Quality of life in obstructive sleep apnea: a systematic review of the literature. Sleep Med 2(6):477–491CrossRef
13.
Zurück zum Zitat Sutherland K, Vanderveken OM, Tsuda H, Marklund M, Gagnadoux F, Kushida CA, Cistulli PA (2014) Oral appliance treatment for obstructive sleep apnea: an update. J Clin Sleep Med 10(2):215–227CrossRef Sutherland K, Vanderveken OM, Tsuda H, Marklund M, Gagnadoux F, Kushida CA, Cistulli PA (2014) Oral appliance treatment for obstructive sleep apnea: an update. J Clin Sleep Med 10(2):215–227CrossRef
14.
Zurück zum Zitat Kuhn E, Schwarz EI, Bratton DJ, Rossi VA, Kohler M (2017) Effects of CPAP and mandibular advancement devices on health-related quality of life in OSA: a systematic review and meta-analysis. Chest 151(4):786–794CrossRef Kuhn E, Schwarz EI, Bratton DJ, Rossi VA, Kohler M (2017) Effects of CPAP and mandibular advancement devices on health-related quality of life in OSA: a systematic review and meta-analysis. Chest 151(4):786–794CrossRef
15.
Zurück zum Zitat Weaver TE, Laizner AM, Evans LK, Maislin G, Chugh DK, Lyon K, ..., Dinges DE (1997) An instrument to measure functional status outcomes for disorders of excessive sleepiness. Sleep: 20(10): 835-843 Weaver TE, Laizner AM, Evans LK, Maislin G, Chugh DK, Lyon K, ..., Dinges DE (1997) An instrument to measure functional status outcomes for disorders of excessive sleepiness. Sleep: 20(10): 835-843
16.
Zurück zum Zitat Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). Medical care 473:483 Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). Medical care 473:483
17.
Zurück zum Zitat Flemons WW, Reimer MA (2002) Measurement properties of the Calgary sleep apnea quality of life index. Am J Respir Crit Care Med 165(2):159–164CrossRef Flemons WW, Reimer MA (2002) Measurement properties of the Calgary sleep apnea quality of life index. Am J Respir Crit Care Med 165(2):159–164CrossRef
18.
Zurück zum Zitat ROBINS-I (2016) a tool for assessing risk of bias in non-randomized studies of interventions BMJ 355; i4919 ROBINS-I (2016) a tool for assessing risk of bias in non-randomized studies of interventions BMJ 355; i4919
19.
Zurück zum Zitat Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD et al (2011) BMJ 343:d5928CrossRef Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD et al (2011) BMJ 343:d5928CrossRef
20.
Zurück zum Zitat Engleman HM, McDonald JP, Graham D et al (2002) Randomized crossover trial of two treatments for sleep apnea/hypopnea syndrome: continuous positive airway pressure and mandibular repositioning splint. Am J Respir Crit Care Med 166(6):855–859CrossRef Engleman HM, McDonald JP, Graham D et al (2002) Randomized crossover trial of two treatments for sleep apnea/hypopnea syndrome: continuous positive airway pressure and mandibular repositioning splint. Am J Respir Crit Care Med 166(6):855–859CrossRef
21.
Zurück zum Zitat Barnes M, McEvoy RD, Banks S, Tarquinio N, Murray CG, Vowles N, Pierce RJ (2004) Efficacy of positive airway pressure and oral appliance in mild to moderate obstructive sleep apnea. Am J Respir Crit Care Med 170(6):656–664CrossRef Barnes M, McEvoy RD, Banks S, Tarquinio N, Murray CG, Vowles N, Pierce RJ (2004) Efficacy of positive airway pressure and oral appliance in mild to moderate obstructive sleep apnea. Am J Respir Crit Care Med 170(6):656–664CrossRef
22.
Zurück zum Zitat Machado MAC, Prado LBFD, Carvalho LBCD, Francisco S, Silva ABD, Atallah ÁN, Prado GFD (2004) Quality of life of patients with obstructive sleep apnea syndrome treated with an intraoral mandibular repositioner. Arq Neuropsiquiatr 62(2a):222–225CrossRef Machado MAC, Prado LBFD, Carvalho LBCD, Francisco S, Silva ABD, Atallah ÁN, Prado GFD (2004) Quality of life of patients with obstructive sleep apnea syndrome treated with an intraoral mandibular repositioner. Arq Neuropsiquiatr 62(2a):222–225CrossRef
23.
Zurück zum Zitat Blanco J, Zamarron C, Pazos MA, Lamela C, Quintanilla DS (2005) Prospective evaluation of an oral appliance in the treatment of obstructive sleep apnea syndrome. Sleep and Breathing 9(1):20–25CrossRef Blanco J, Zamarron C, Pazos MA, Lamela C, Quintanilla DS (2005) Prospective evaluation of an oral appliance in the treatment of obstructive sleep apnea syndrome. Sleep and Breathing 9(1):20–25CrossRef
24.
Zurück zum Zitat Lawton HM, Battagel JM, Kotecha B (2005) A comparison of the Twin Block and Herbst mandibular advancement splints in the treatment of patients with obstructive sleep apnoea: a prospective study. The European Journal of Orthodontics 27(1):82–90CrossRef Lawton HM, Battagel JM, Kotecha B (2005) A comparison of the Twin Block and Herbst mandibular advancement splints in the treatment of patients with obstructive sleep apnoea: a prospective study. The European Journal of Orthodontics 27(1):82–90CrossRef
25.
Zurück zum Zitat Johal A (2006) Health-related quality of life in patients with sleep-disordered breathing: effect of mandibular advancement appliances. J Prosthet Dent 96(4):298–302CrossRef Johal A (2006) Health-related quality of life in patients with sleep-disordered breathing: effect of mandibular advancement appliances. J Prosthet Dent 96(4):298–302CrossRef
26.
Zurück zum Zitat Lam B, Sam K, Mok WY, Cheung MT, Fong DY, Lam JC, ..., Mary SM (2007) Randomised study of three non-surgical treatments in mild to moderate obstructive sleep apnoea. Thorax 62(4): 354-359 Lam B, Sam K, Mok WY, Cheung MT, Fong DY, Lam JC, ..., Mary SM (2007) Randomised study of three non-surgical treatments in mild to moderate obstructive sleep apnoea. Thorax 62(4): 354-359
27.
Zurück zum Zitat Hoekema A, Stegenga B, Wijkstra PJ, Van der Hoeven JH, Meinesz AF, De Bont LG (2008 Sep) Obstructive sleep apnea therapy. J Dent Res 87(9):882–887CrossRef Hoekema A, Stegenga B, Wijkstra PJ, Van der Hoeven JH, Meinesz AF, De Bont LG (2008 Sep) Obstructive sleep apnea therapy. J Dent Res 87(9):882–887CrossRef
28.
Zurück zum Zitat Petri N, Svanholt P, Solow B, Wildschiødtz G, Winkel P (2008) Mandibular advancement appliance for obstructive sleep apnoea: results of a randomised placebo controlled trial using parallel group design. J Sleep Res 17(2):221–229CrossRef Petri N, Svanholt P, Solow B, Wildschiødtz G, Winkel P (2008) Mandibular advancement appliance for obstructive sleep apnoea: results of a randomised placebo controlled trial using parallel group design. J Sleep Res 17(2):221–229CrossRef
29.
Zurück zum Zitat Vecchierini MF, Leger D, Laaban JP, Putterman G, Figueredo M, Levy J, ..., Philip P (2008) Efficacy and compliance of mandibular repositioning device in obstructive sleep apnea syndrome under a patient-driven protocol of care. Sleep medicine 9(7): 762-769 Vecchierini MF, Leger D, Laaban JP, Putterman G, Figueredo M, Levy J, ..., Philip P (2008) Efficacy and compliance of mandibular repositioning device in obstructive sleep apnea syndrome under a patient-driven protocol of care. Sleep medicine 9(7): 762-769
30.
Zurück zum Zitat Gauthier L, Laberge L, Beaudry M, Laforte M, Rompré PH, Lavigne GJ (2009) Efficacy of two mandibular advancement appliances in the management of snoring and mild-moderate sleep apnea: a cross-over randomized study. Sleep Med 10(3):329–336CrossRef Gauthier L, Laberge L, Beaudry M, Laforte M, Rompré PH, Lavigne GJ (2009) Efficacy of two mandibular advancement appliances in the management of snoring and mild-moderate sleep apnea: a cross-over randomized study. Sleep Med 10(3):329–336CrossRef
31.
Zurück zum Zitat Aarab G, Lobbezoo F, Hamburger HL, Naeije M (2011) Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea: a randomized, placebo-controlled trial. Respiration 81(5):411–419CrossRef Aarab G, Lobbezoo F, Hamburger HL, Naeije M (2011) Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea: a randomized, placebo-controlled trial. Respiration 81(5):411–419CrossRef
32.
Zurück zum Zitat Gauthier L, Laberge L, Beaudry M, Laforte M, Rompré PH, Lavigne GJ (2011) Mandibular advancement appliances remain effective in lowering respiratory disturbance index for 2.5–4.5 years. Sleep medicine 12(9):844–849CrossRef Gauthier L, Laberge L, Beaudry M, Laforte M, Rompré PH, Lavigne GJ (2011) Mandibular advancement appliances remain effective in lowering respiratory disturbance index for 2.5–4.5 years. Sleep medicine 12(9):844–849CrossRef
33.
Zurück zum Zitat Phillips CL, Grunstein RR, Darendeliler MA, Mihailidou AS, Srinivasan VK, Yee BJ, ..., Cistulli PA (2013) Health outcomes of continuous positive airway pressure versus oral appliance treatment for obstructive sleep apnea: a randomized controlled trial. American journal of respiratory and critical care medicine 187(8): 879-887 Phillips CL, Grunstein RR, Darendeliler MA, Mihailidou AS, Srinivasan VK, Yee BJ, ..., Cistulli PA (2013) Health outcomes of continuous positive airway pressure versus oral appliance treatment for obstructive sleep apnea: a randomized controlled trial. American journal of respiratory and critical care medicine 187(8): 879-887
34.
Zurück zum Zitat Schütz TCB, Cunha TCA, Moura-Guimaraes T, Luz GP, Ackel-D'Elia C, Alves, EDS, ..., Bittencourt L (2013) Comparison of the effects of continuous positive airway pressure, oral appliance and exercise training in obstructive sleep apnea syndrome. Clinics 68: 1168-1174 Schütz TCB, Cunha TCA, Moura-Guimaraes T, Luz GP, Ackel-D'Elia C, Alves, EDS, ..., Bittencourt L (2013) Comparison of the effects of continuous positive airway pressure, oral appliance and exercise training in obstructive sleep apnea syndrome. Clinics 68: 1168-1174
35.
Zurück zum Zitat Doff MH, Hoekema A, Wijkstra PJ, van der Hoeven JH, Huddleston Slater JJ, de Bont LG, Stegenga B (2013) Oral appliance versus continuous positive airway pressure in obstructive sleep apnea syndrome: a 2-year follow-up. Sleep 36(9):1289–1296CrossRef Doff MH, Hoekema A, Wijkstra PJ, van der Hoeven JH, Huddleston Slater JJ, de Bont LG, Stegenga B (2013) Oral appliance versus continuous positive airway pressure in obstructive sleep apnea syndrome: a 2-year follow-up. Sleep 36(9):1289–1296CrossRef
36.
Zurück zum Zitat Quinnell TG, Bennett M, Jordan J, Clutterbuck-James AL, Davies MG, Smith, IE, ..., Sharples LD (2014) A crossover randomised controlled trial of oral mandibular advancement devices for obstructive sleep apnoea-hypopnoea (TOMADO). Thorax, 69(10), 938-945 Quinnell TG, Bennett M, Jordan J, Clutterbuck-James AL, Davies MG, Smith, IE, ..., Sharples LD (2014) A crossover randomised controlled trial of oral mandibular advancement devices for obstructive sleep apnoea-hypopnoea (TOMADO). Thorax, 69(10), 938-945
37.
Zurück zum Zitat Banhiran W, Kittiphumwong P, Assanasen P, Chongkolwatana C, Metheetrairut C (2014) Adjustable thermoplastic mandibular advancement device for obstructive sleep apnea: outcomes and practicability. Laryngoscope 124(10):2427–2432CrossRef Banhiran W, Kittiphumwong P, Assanasen P, Chongkolwatana C, Metheetrairut C (2014) Adjustable thermoplastic mandibular advancement device for obstructive sleep apnea: outcomes and practicability. Laryngoscope 124(10):2427–2432CrossRef
38.
Zurück zum Zitat Marklund M, Carlberg B, Forsgren L, Olsson T, Stenlund H, Franklin KA (2015) Oral appliance therapy in patients with daytime sleepiness and snoring or mild to moderate sleep apnea: a randomized clinical trial. JAMA Intern Med 175(8):1278–1285CrossRef Marklund M, Carlberg B, Forsgren L, Olsson T, Stenlund H, Franklin KA (2015) Oral appliance therapy in patients with daytime sleepiness and snoring or mild to moderate sleep apnea: a randomized clinical trial. JAMA Intern Med 175(8):1278–1285CrossRef
39.
Zurück zum Zitat Bhushan A, Tripathi A, Gupta A, Tripathi S (2015) The effects of an oral appliance in obstructive sleep apnea patients with prehypertension. J Dent Sleep Med 2:37–43 Bhushan A, Tripathi A, Gupta A, Tripathi S (2015) The effects of an oral appliance in obstructive sleep apnea patients with prehypertension. J Dent Sleep Med 2:37–43
40.
Zurück zum Zitat Benoist L, de Ruiter M, de Lange J, de Vries N (2017) A randomized, controlled trial of positional therapy versus oral appliance therapy for position-dependent sleep apnea. Sleep Med 34:109–117CrossRef Benoist L, de Ruiter M, de Lange J, de Vries N (2017) A randomized, controlled trial of positional therapy versus oral appliance therapy for position-dependent sleep apnea. Sleep Med 34:109–117CrossRef
41.
Zurück zum Zitat Gagnadoux F, Nguyen XL, Le Vaillant M, Priou P, Meslier N, Eberlein A, ..., Launois S (2017) Comparison of titrable thermoplastic versus custom-made mandibular advancement device for the treatment of obstructive sleep apnoea. Respiratory medicine 131: 35-42 Gagnadoux F, Nguyen XL, Le Vaillant M, Priou P, Meslier N, Eberlein A, ..., Launois S (2017) Comparison of titrable thermoplastic versus custom-made mandibular advancement device for the treatment of obstructive sleep apnoea. Respiratory medicine 131: 35-42
42.
Zurück zum Zitat Cunha TC, Guimaraes TD, Schultz TC, Almeida FR, Cunha TM, Simamoto Junior PC, Bittencourt LR (2017) Predictors of success for mandibular repositioning appliance in obstructive sleep apnea syndrome. Brazilian Oral Research 31 Cunha TC, Guimaraes TD, Schultz TC, Almeida FR, Cunha TM, Simamoto Junior PC, Bittencourt LR (2017) Predictors of success for mandibular repositioning appliance in obstructive sleep apnea syndrome. Brazilian Oral Research 31
43.
Zurück zum Zitat Fernández-Julián E, Pérez-Carbonell T, Marco R, Pellicer V, Rodriguez-Borja E, Marco J (2018) Impact of an oral appliance on obstructive sleep apnea severity, quality of life, and biomarkers. Laryngoscope 128(7):1720–1726CrossRef Fernández-Julián E, Pérez-Carbonell T, Marco R, Pellicer V, Rodriguez-Borja E, Marco J (2018) Impact of an oral appliance on obstructive sleep apnea severity, quality of life, and biomarkers. Laryngoscope 128(7):1720–1726CrossRef
44.
Zurück zum Zitat de Ruiter MH, Benoist LB, de Vries N, de Lange J (2018) Durability of treatment effects of the Sleep Position Trainer versus oral appliance therapy in positional OSA: 12-month follow-up of a randomized controlled trial. Sleep and Breathing 22(2):441–450CrossRef de Ruiter MH, Benoist LB, de Vries N, de Lange J (2018) Durability of treatment effects of the Sleep Position Trainer versus oral appliance therapy in positional OSA: 12-month follow-up of a randomized controlled trial. Sleep and Breathing 22(2):441–450CrossRef
45.
Zurück zum Zitat Ahrens A, McGrath C, Hägg U (2010) Subjective efficacy of oral appliance design features in the management of obstructive sleep apnea: a systematic review. Am J Orthod Dentofac Orthop 138(5):559–576CrossRef Ahrens A, McGrath C, Hägg U (2010) Subjective efficacy of oral appliance design features in the management of obstructive sleep apnea: a systematic review. Am J Orthod Dentofac Orthop 138(5):559–576CrossRef
46.
Zurück zum Zitat Vroegop AV, Vanderveken OM, Van de Heyning PH, Braem (MJ, (2012) Effects of vertical opening on pharyngeal dimensions in patients with obstructive sleep apnoea. Sleep Med 13(3):314–316CrossRef Vroegop AV, Vanderveken OM, Van de Heyning PH, Braem (MJ, (2012) Effects of vertical opening on pharyngeal dimensions in patients with obstructive sleep apnoea. Sleep Med 13(3):314–316CrossRef
47.
Zurück zum Zitat Pitsis AJ, Darendeliler MA, Gotsopoulos H, Petocz P, Cistulli PA (2002) Effect of vertical dimension on efficacy of oral appliance therapy in obstructive sleep apnea. Am J Respir Crit Care Med 166:860–864CrossRef Pitsis AJ, Darendeliler MA, Gotsopoulos H, Petocz P, Cistulli PA (2002) Effect of vertical dimension on efficacy of oral appliance therapy in obstructive sleep apnea. Am J Respir Crit Care Med 166:860–864CrossRef
48.
Zurück zum Zitat Vanderveken OM, Devolder A, Marklund M, Boudewyns AN, Braem MJ, Okkerse W, Verbraecken JA, Franklin KA, De Backer WA, Van de Heyning PH (2008) Comparison of a custom-made and a thermoplastic oral appliance for the treatment of mild sleep apnea. Am J Respir Crit Care Med 178:197–202CrossRef Vanderveken OM, Devolder A, Marklund M, Boudewyns AN, Braem MJ, Okkerse W, Verbraecken JA, Franklin KA, De Backer WA, Van de Heyning PH (2008) Comparison of a custom-made and a thermoplastic oral appliance for the treatment of mild sleep apnea. Am J Respir Crit Care Med 178:197–202CrossRef
49.
Zurück zum Zitat Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545CrossRef Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545CrossRef
Metadaten
Titel
Impact of oral appliance therapy on quality of life (QoL) in patients with obstructive sleep apnea — a systematic review and meta-analysis
verfasst von
Hita Rangarajan
Sridevi Padmanabhan
Sukanya Ranganathan
Vignesh Kailasam
Publikationsdatum
13.09.2021
Verlag
Springer International Publishing
Erschienen in
Sleep and Breathing / Ausgabe 3/2022
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-021-02483-0

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