Patient-reported quality of life outcomes with mandibular advancement versus continuous positive airway pressure: insights from the CRESCENT trial.

IF 4.9 2区医学 Q1 Medicine Sleep Pub Date : 2025-11-10 DOI:10.1093/sleep/zsaf022

Juliana Tereza Colpani, Yi-Hui Ou, Annushiah Vasan Thakumar, Crystal S Cheong, Weiqiang Loke, Ching-Hui Sia, Yao-Hao Teo, Siew-Pang Chan, Calvin W Chin, Pipin Kojodjojo, Mark Y Chan, Peter A Cistulli, Nan Luo, Chi-Hang Lee

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Abstract

Study objectives: We compared mandibular advancement device (MAD) versus continuous positive airway pressure (CPAP) on quality-of-life (QoL) in a prespecified analysis of the CRESCENT trial.

Methods: Two hundred and twenty participants over age 40 with Obstructive sleep apnea (OSA), hypertension, and increased cardiovascular risk from three public hospitals were randomly assigned to MAD or CPAP (1:1). Multi-dimensional QoL questionnaires were administered at baseline, 6 months, and 12 months. Three sleep-related QoL questionnaires: Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), and Sleep Apnea Quality of Life Index (SAQLI). Two generic QoL questionnaires: EuroQoL 5-D (EQ-5D) and Short Form 36 Health Survey (SF36).

Results: MAD adherence was 5.5 (3.9-6.9) hours at 6 months and 5.0 (3.3-6.1) hours at 12 months. CPAP adherence was 4.9 (3.3-6.1) hours at 6 months and 4.8 (3.3-5.7) hours at 12 months. Both groups showed improvements in sleep-related QoL. ESS improved at 6 and 12 months (p < .001), with a between-group difference favoring CPAP at 6 months (Δ 1.45 [0.44 to 2.46], p = .005). FOSQ improved at 6 and 12 months (p < .001), with a between-group difference favoring CPAP at 12 months (Δ -0.91 [-1.77 to -0.05], p = .038). SAQLI improved at 6 and 12 months (p < .001) without between-group differences. For generic QoL questionnaires, SF-36 improved in most domains at 6 and 12 months, with the Social Functioning section favoring CPAP at 12 months (p = .013). EQ-5D improved at 12 months, with a trend favoring CPAP (p = .053).

Conclusions: MAD and CPAP effectively improved sleep-related QoL and some aspects of generic QoL. CPAP improved sleep-related QoL to a greater extent than MAD.

Clinical trial name: The Cardiosleep Research Program on OSA, Blood Pressure Control and Maladaptive Myocardial Remodeling-Non-inferiority Trial (CRESCENT). URL: https://clinicaltrials.gov/study/NCT04119999?locStr=Singapore&country=Singapore&cond=Obstructive%20Sleep%20Apnea&aggFilters=ages:adult%20older,studyType:int&rank=6TRIAL REGISTRATION: NCT04119999.

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患者报告的下颌推进与CPAP的生活质量结果：来自CRESCENT试验的见解。

研究目的：在CRESCENT试验的预先分析中，我们比较了下颌推进装置（MAD）与CPAP对生活质量（QoL）的影响。方法：来自三家公立医院的220名年龄超过40岁的OSA、高血压和心血管风险增加的参与者随机分配到MAD或CPAP（1:1）。多维生活质量问卷在基线、6个月和12个月进行。三份与睡眠相关的生活质量问卷：Epworth嗜睡量表（ESS）、睡眠功能结局问卷（FOSQ）和睡眠呼吸暂停生活质量指数（SAQLI）。两份通用的生活质量调查问卷：EuroQoL 5-D （EQ-5D）和简明36健康调查（SF36）。结果：MAD依从性为6个月时5.5（3.9-6.9）小时，12个月时5.0（3.3-6.1）小时。6个月时CPAP依从性为4.9（3.3-6.1）小时，12个月时为4.8（3.3-5.7）小时。两组的睡眠相关生活质量都有所改善。结论：MAD和CPAP可有效改善睡眠相关生活质量和一般生活质量的某些方面。CPAP比MAD更能改善睡眠相关的生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep Medicine-Neurology (clinical)

CiteScore

8.70

自引率

10.70%

发文量

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