Sleep & breathing = Schlaf & Atmung · 2025
Comparative effects of MAD and CPAP on heart rate in obstructive sleep apnea.
СтатьяСравнительное исследованиеНаблюдательное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Tondo Pasquale, Lorusso Mauro, Esperouz Fariba, Giannini Giuseppina, Burlon Giuseppe, Natale Matteo Pio, Sabato Roberto, Scioscia Giulia, Leonardo Monteleone, Trono Giulio, Tepedino Michele, Russo Lucio Lo, Lacedonia Donato, Ciavarella Domenico
Аннотация
PURPOSE: This observational study aimed to compare the effectiveness of mandibular advancement devices (MAD) and continuous positive airway pressure (CPAP) therapy in patients diagnosed with obstructive sleep apnea (OSA), with a specific focus on changes in heart rate parameters.
METHODS: Fifty-two patients treated with MAD were compared with fifty-two patients treated with CPAP. All participants underwent sleep study prior to the initiation of therapy (T0), followed by a control sleep study after a (3-month) predefined treatment period (T1). Changes in cardiac parameters between baseline (T0) and post-treatment (T1) were analyzed both within each group (MAD and CPAP) and between groups. To enhance comparability between patients treated with MAD and those treated with CPAP, a propensity score matching approach was applied based on pre-treatment variables, in order to minimize selection bias and optimize the validity of the between-group comparison.
RESULTS: For intragroup comparisons, both the MAD and C-PAP groups demonstrated statistically significant reductions in AHI and ODI following treatment (p < 0.001). Additionally, a modest but significant decrease in mean heart rate was noted in both groups (MAD: p = 0.033; CPAP: p = 0.002). For intergroup comparisons, both treatment modalities resulted in a significant reduction in AHI and ODI values. Regarding heart rate parameters, no statistically significant differences were observed between the two groups after treatment for mean HR (p = 0.350), minimum HR (p = 0.602), or maximum HR (p = 0.942).
CONCLUSION: The use of MAD and CPAP leads to significant improvements in heart rate in patients with OSA. However, no significant differences were found between the two treatment modalities in terms of heart rate reduction.
METHODS: Fifty-two patients treated with MAD were compared with fifty-two patients treated with CPAP. All participants underwent sleep study prior to the initiation of therapy (T0), followed by a control sleep study after a (3-month) predefined treatment period (T1). Changes in cardiac parameters between baseline (T0) and post-treatment (T1) were analyzed both within each group (MAD and CPAP) and between groups. To enhance comparability between patients treated with MAD and those treated with CPAP, a propensity score matching approach was applied based on pre-treatment variables, in order to minimize selection bias and optimize the validity of the between-group comparison.
RESULTS: For intragroup comparisons, both the MAD and C-PAP groups demonstrated statistically significant reductions in AHI and ODI following treatment (p < 0.001). Additionally, a modest but significant decrease in mean heart rate was noted in both groups (MAD: p = 0.033; CPAP: p = 0.002). For intergroup comparisons, both treatment modalities resulted in a significant reduction in AHI and ODI values. Regarding heart rate parameters, no statistically significant differences were observed between the two groups after treatment for mean HR (p = 0.350), minimum HR (p = 0.602), or maximum HR (p = 0.942).
CONCLUSION: The use of MAD and CPAP leads to significant improvements in heart rate in patients with OSA. However, no significant differences were found between the two treatment modalities in terms of heart rate reduction.