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Diagnosis and Treatment of Obstructive Sleep Apnea in Adults

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Comparative Effectiveness of Continuous Positive Airway Pressure Machines Versus Mandibular Advancement Devices

There is a moderate strength of evidence that continuous positive airway pressure (CPAP) and mandibular advancement devices (MAD) are effective treatments for obstructive sleep apnea and improve sleepiness and lower apnea-hypopnea index (AHI) values when compared to control treatments or no treatment. There is also a moderate strength of evidence that CPAP is superior to MAD in achieving an AHI of ≤ 5 events per hour. However, there is insufficient evidence to determine which patients might benefit most from treatment with CPAP, MAD, or CPAP compared to MAD. Note that studies of MAD predominantly exclude patients with comorbidities or unsafe levels of sleepiness. It is also important to note that current research evaluates only intermediate outcomes, and thus these findings may not apply to long-term clinical outcomes.