Patient-Reported Quality of Life Outcomes with Mandibular Advancement versus CPAP: Insights from the CRESCENT Trial.

IF 5.6 2区医学 Q1 Medicine Sleep Pub Date : 2025-01-31 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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引用次数: 0

Abstract

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

Methods: 220 participants over age 40 with 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<0.001), with a between-group difference favoring CPAP at 6 months (Δ 1.45 [0.44 to 2.46], p=0.005). FOSQ improved at 6 and 12 months (p<0.001), with a between-group difference favoring CPAP at 12 months (Δ -0.91 [-1.77 to -0.05], p=0.038). SAQLI improved at 6 and 12 months (p<0.001) without between-group difference. For generic QoL questionnaires, SF-36 improved in most domains at 6 and 12 months, with Social Functioning section favoring CPAP at 12 months (p=0.013). EQ-5D improved at 12 months, with a trend favoring CPAP (p=0.053).

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.

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来源期刊

Sleep Medicine-Neurology (clinical)

CiteScore

8.70

自引率

10.70%

发文量

期刊介绍： SLEEP® publishes findings from studies conducted at any level of analysis, including: Genes Molecules Cells Physiology Neural systems and circuits Behavior and cognition Self-report SLEEP® publishes articles that use a wide variety of scientific approaches and address a broad range of topics. These may include, but are not limited to: Basic and neuroscience studies of sleep and circadian mechanisms In vitro and animal models of sleep, circadian rhythms, and human disorders Pre-clinical human investigations, including the measurement and manipulation of sleep and circadian rhythms Studies in clinical or population samples. These may address factors influencing sleep and circadian rhythms (e.g., development and aging, and social and environmental influences) and relationships between sleep, circadian rhythms, health, and disease Clinical trials, epidemiology studies, implementation, and dissemination research.