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Oral appliances that advance the mandible are effective treatments for patients with mild obstructive sleep apnea (OSA). However, in most studies, investigators have not compared the relative effectiveness of oral appliances and continuous positive airway pressure (CPAP) in the same patients. In this study, researchers examined the efficacy of both approaches in 378 patients with OSA. They used an adjustable appliance that was titrated for optimal effect by turning a dial that changed the degree of jaw protrusion.
At baseline, the cohort had roughly equal proportions of patients with mild, moderate, or severe OSA (corresponding to apnea-hypopnea indexes [AHI] of 5–15, 15–30, and >30 events per hour). During appliance use, the AHI fell to <5 …