Health-Related Quality of Life and Sleep Quality after 12 Months of Treatment in Nonsevere Obstructive Sleep Apnea: A Randomized Clinical Trial with Continuous Positive Airway Pressure and Mandibular Advancement Splints

Lars M Berg; Torun K S Ankjell; Yi-Qian Sun; Tordis A Trovik; Oddveig G Rikardsen; Anders Sjögren; Ketil Moen; Sølve Hellem; Vegard Bugten

doi:10.1155/2020/2856460

Health-Related Quality of Life and Sleep Quality after 12 Months of Treatment in Nonsevere Obstructive Sleep Apnea: A Randomized Clinical Trial with Continuous Positive Airway Pressure and Mandibular Advancement Splints

Int J Otolaryngol. 2020 Jun 30:2020:2856460. doi: 10.1155/2020/2856460. eCollection 2020.

Authors

Lars M Berg¹, Torun K S Ankjell^{2

3}, Yi-Qian Sun^{4

5}, Tordis A Trovik⁶, Oddveig G Rikardsen^{2

3}, Anders Sjögren¹, Ketil Moen⁷, Sølve Hellem⁸, Vegard Bugten^{9

10}

Affiliations

¹ Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
² ENT Department, University Hospital in Northern Norway, Tromsø, Norway.
³ Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
⁴ Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway.
⁵ Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway.
⁶ Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
⁷ ENT Department, Section for Oral and Maxillofacial Surgery, Arendal Hospital, Arendal, Norway.
⁸ Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway.
⁹ Department of Otorhinolaryngology, Head and Neck Surgery, St. Olav's University Hospital, Trondheim, Norway.
¹⁰ Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway.

Abstract

In this randomized controlled trial, patients with nonsevere obstructive sleep apnea (OSA) were treated with continuous positive airway pressure (CPAP) or a twin block mandibular advancement splint (MAS). The primary objective was to compare how CPAP and MAS treatments change the health-related quality of life (HRQoL) and self-reported sleep quality of patients after 12 months of treatment. In total, 104 patients were recruited: 55 were allocated to the CPAP treatment group and 49 to the MAS treatment group. We used the SF36 questionnaire to evaluate HRQoL and the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. All patients were included in the intention-to-treat analyses. These analyses showed improvements in the SF36 physical component score (from 48.8 ± 7.6 at baseline to 50.5 ± 8.0 at follow-up, p=0.03) in the CPAP treatment group and in the mental component score (from 44.9 ± 12.1 to 49.3 ± 9.2, p=0.009) in the MAS treatment group. The PSQI global score improved in both the CPAP (from 7.7 ± 3.5 to 6.6 ± 2.9, p=0.006) and the MAS (8.0 ± 3.1 to 6.1 ± 2.6, p < 0.001) treatment groups. No difference was found between the treatment groups in any of the SF36 scores or PSQI global score at the final follow-up (p > 0.05) in any analysis. The improvement in the SF36 vitality domain moderately correlated to the improvement in the PSQI global score in both groups (CPAP: |r|=0.47, p < 0.001; MAS: |r|=0.36, p=0.01). In the MAS treatment group, we also found a weak correlation between improvements in the SF36 mental component score and PSQI global score (|r|=0.28, p=0.05). In conclusion, CPAP and MAS treatments lead to similar improvements in the HRQoL and self-reported sleep quality in nonsevere OSA. Improvements in aspects of HRQoL seem to be moderately correlated to the self-reported sleep quality in both CPAP and MAS treatments.