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The effects of continuous positive airway pressure and mandibular advancement therapy on metabolic outcomes of patients with mild obstructive sleep apnea: a randomized controlled study.
E Silva, Luciana Oliveira; Guimarães, Thais Moura; Pontes, Gabriela; Coelho, Glaury; Badke, Luciana; Fabbro, Cibele Dal; Tufik, Sergio; Bittencourt, Lia; Togeiro, Sonia.
Afiliação
  • E Silva LO; Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, Vila Clementino, São Paulo, CEP 04021-002, Brazil.
  • Guimarães TM; Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, Vila Clementino, São Paulo, CEP 04021-002, Brazil.
  • Pontes G; Departamento de Pneumologia, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Coelho G; Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, Vila Clementino, São Paulo, CEP 04021-002, Brazil.
  • Badke L; Departamento de Pneumologia, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Fabbro CD; Instituto do Sono, São Paulo, Brazil.
  • Tufik S; Center for Advanced Research in Sleep Medicine, Research Center of Faculty of Dental Medicine, Université de Montréal, Montréal, Canada.
  • Bittencourt L; Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, Vila Clementino, São Paulo, CEP 04021-002, Brazil.
  • Togeiro S; Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, Vila Clementino, São Paulo, CEP 04021-002, Brazil.
Sleep Breath ; 25(2): 797-805, 2021 Jun.
Article em En | MEDLINE | ID: mdl-33394328
BACKGROUND: Moderate and severe obstructive sleep apnea (OSA) have been independently associated with dyslipidemia. The results of metabolic improvement with continuous positive airway pressure (CPAP) have been controversial. Less evidence exists regarding this issue in mild OSA. A current treatment for mild OSA is mandibular advancement device (MAD) therapy, but its effectiveness on the metabolic profile needs to be compared with CPAP. The purpose of this study was to compare MAD vs CPAP vs no treatment on the metabolic profile during 6 and 12 months of follow-up in patients with mild OSA. METHODS: The inclusion criteria were patients with mild OSA, both genders, ages 18 to 65 years, and body mass index (BMI) of < 35 Kg/m2. Patients were randomized in 3 groups (CPAP, MAD, and control). The evaluations included physical examination, metabolic profile, and full polysomnography at baseline, 6 months, and 12 months of follow-up. RESULTS: Seventy-nine patients with mild OSA were randomized in three treatment groups, with mean age (± SD) of 47 ± 9 years, 54% men, and AHI 9.5 ± 2.9 events/h. MAD and CPAP reduced AHI at 6 and 12 months compared to the control group. MAD adherence was higher than CPAP at 6 and 12 months. Despite lower adherence compared to MAD, CPAP was more effective in reducing total cholesterol over 12 months (baseline 189.3 ± 60.2 mg/dl to 173.4 ± 74.3 mg/dl) and low-density lipoprotein cholesterol (LDL-c, baseline 112.8 ± 54.9 mg/dl to 94.5 ± 67.4 mg/dl). CONCLUSIONS: After 1 year of treatment, CPAP was superior to MAD in reducing total cholesterol and LDL-c in patients with mild OSA.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Avanço Mandibular / Apneia Obstrutiva do Sono / Pressão Positiva Contínua nas Vias Aéreas Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Avanço Mandibular / Apneia Obstrutiva do Sono / Pressão Positiva Contínua nas Vias Aéreas Idioma: En Ano de publicação: 2021 Tipo de documento: Article