This forest plot displays 4 crossover studies and 1 parallel design trial. The trials may have heterogeneous results with net differences ranging from 1.8 to 15.2 events per hour, favoring CPAP. Overall, the summary net difference was 3.5 events per hour (95 percent confidence interval 1.5 to 5.5), P<0.001, favoring CPAP over mandibular advancement devices, with borderline statistical heterogeneity (I-squared = 47 percent, P=0.109). The result of the parallel design trial (2.4 events per hour) falls within the range of results of the crossover studies (1.8 to 15.2 events per hour).

Figure 25Meta-analysis of arousal index (events/hr) in randomized controlled trials of mandibular advancement devices vs. CPAP, by study design

AHI = apnea-hypopnea index, AI = arousal index, CI = confidence interval, CPAP = continuous positive airway pressure, MAD = mandibular advancement device.

From: Results

Cover of Diagnosis and Treatment of Obstructive Sleep Apnea in Adults
Diagnosis and Treatment of Obstructive Sleep Apnea in Adults [Internet].
Comparative Effectiveness Reviews, No. 32.
Balk EM, Moorthy D, Obadan NO, et al.

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