Continuous positive airway pressure versus standard care for the treatment of people with mild obstructive sleep apnoea (MERGE): a multicentre, randomised controlled trial

Wimms, Alison; Kelly, Julia L.; Turnbull, Chris D.; McMillan, Alison; Craig, Sonya; O’Reilly, John; Nickol, Annabel H.; West, Sophie; Simonds, Anita K.; Withana, Shirmila; Pepperell, Justin Ct; Ward, NR; Kent, Brian D.; Quinnell, Timothy; Paracha, Mohammad; Anderson, William; Hedley, Emma; Decker, Meredith; Willes, Leslee; Calverley, Peter M.A.; Benjafield, Adam; Stradling, John; Morrell, Mary J.

doi:10.1016/s2213-2600(19)30402-3

Cited by 66 publications

(56 citation statements)

References 30 publications

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“…Conversely, treatment‐responsive OSA patients with an AHI < 15 per hr may be wrongly excluded from participation or may be included in control groups. A recent randomised controlled trial on the therapeutic effects of CPAP showed robust improvements of quality of life indices in mild OSA (Wimms et al., 2019). CPAP would have been denied to these subjects in standard practice, because an AHI < 15 per hr commonly constitutes an exclusion criterion.…”

Section: Part 1: Historical Reviewmentioning

confidence: 99%

On the rise and fall of the apnea−hypopnea index: A historical review and critical appraisal

Pevernagie

Gnidovec-Stražišar

Grote

et al. 2020

Journal of Sleep Research

178

134

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The publication of "The Sleep Apnea Syndromes" by Guilleminault et al. in the 1970s hallmarked the discovery of a new disease entity involving serious health consequences. Obstructive sleep apnea was shown to be the most important disorder among the sleep apnea syndromes (SAS). In the course of time, it was found that the prevalence of obstructive sleep apnea reached the proportions of a global epidemic, with a major impact on public health, safety and the economy. Early on, a metric was introduced to gauge the seriousness of obstructive sleep apnea, based on the objective measurement of respiratory events during nocturnal sleep. The apnea index and later on the apnea−hypopnea index, being the total count of overnight respiratory events divided by the total sleep time in hours, were embraced as principle measures to establish the diagnosis of obstructive sleep apnea and to rate its severity. The current review summarises the historical evolution of the apnea−hypopnea index, which has been subject to many changes, and has been criticised for not capturing relevant clinical features of obstructive sleep apnea. In fact, the application of

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Section: Part 1: Historical Reviewmentioning

confidence: 99%

On the rise and fall of the apnea−hypopnea index: A historical review and critical appraisal

Pevernagie

Gnidovec-Stražišar

Grote

et al. 2020

Journal of Sleep Research

178

134

View full text Add to dashboard Cite

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“…PAP is the leading therapy and recommended for all patients with moderate to severe OSA (AHI ≥15) [21,22]. Treatment of mild OSA with PAP was recently reported to improve the quality of life of the patients [23]. In OI patients, a removable appliance for bringing the mandible forward is often contradicted as the patients frequently have a relatively prognathic mandible and may suffer from posterior open bite [13,24].…”

Section: Treatment Options For Sleep Apnea In Oimentioning

confidence: 99%

Positive airway pressure therapy for obstructive sleep apnea in patients with Osteogenesis imperfecta: a prospective pilot study

Arponen

Bachour

Bäck

et al. 2021

BMC Musculoskelet Disord

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Background Obstructive sleep apnea (OSA) is prevalent in individuals with Osteogenesis imperfecta (OI). To date, no study has investigated treatment of OSA in adult individuals with OI using positive airway pressure (PAP). This observational pilot study examined the adherence of adults with OI to treatment of OSA with PAP therapy, and the evolution of self-experienced sleepiness and depression symptoms before and after treatment. Methods We included 20 patients, with a mean age of 51 years, who represented varying severity of OI and displayed an apnea and hypopnea index ≥ 5 /sleeping hour as recorded by an overnight polysomnography. PAP therapy was proposed to all patients. Epworth Sleepiness Scale (ESS) questionnaire to evaluate daytime sleepiness, and a validated self-rating depression questionnaire to identify possible depression, were completed prior to PAP therapy and repeated after a minimum of one year. The datasets supporting the conclusions of this article are included within the article. Results From the 20 patients, 15 initiated PAP therapy, and two patients later interrupted it. The mean PAP follow-up period was 1230 days. At baseline, an abnormally high ESS score was reported by 29% of the respondents, and an abnormally high number of symptoms suggesting depression by 29%. Follow-up questionnaires were completed by 60% of the patients, of whom 83% were adherent to PAP treatment. ESS score and depression symptoms did not decrease significantly with PAP therapy. Conclusions Patients with OI accepted well PAP therapy and remained compliant. Sleepiness and depression persisted unaltered despite good PAP adherence. These unexpectedly poor improvements in symptoms by PAP therapy may be due to subjective depression symptoms and the complexity of factors underlying persisting sleepiness in OI. Further research is needed to confirm this novel finding.

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“…Since continuous positive airway pressure (CPAP) can eliminate upper airway narrowing during sleep improving sleep fragmentation, daytime symptoms and quality of life [28,29] , it remains the gold standard treatment for the clinical management of OSA.…”

Section: Obstructive Sleep Apneamentioning

confidence: 99%

Association between non-alcoholic fatty liver disease and obstructive sleep apnea

Umbro¹,

Fabiani²,

Fabiani³

et al. 2020

WJG

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Continuous positive airway pressure versus standard care for the treatment of people with mild obstructive sleep apnoea (MERGE): a multicentre, randomised controlled trial

Cited by 66 publications

References 30 publications

On the rise and fall of the apnea−hypopnea index: A historical review and critical appraisal

On the rise and fall of the apnea−hypopnea index: A historical review and critical appraisal

Positive airway pressure therapy for obstructive sleep apnea in patients with Osteogenesis imperfecta: a prospective pilot study

Association between non-alcoholic fatty liver disease and obstructive sleep apnea

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