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Evidence summaries

Oral Appliances and Functional Orthopaedic Appliances for Obstructive Sleep Apnoea in Children

There is insufficient evidence on the efficacy of oral appliances and functional orthopaedic appliances for obstructive sleep apnoea in children. Level of evidence: "D"

A Cochrane review [Abstract] 1 included 1 study with a total of 23 children. The study compared an oral appliance to no treatment, and assessed apnoea-hypopnoea, daytime symptoms (sleepiness, irritability, tiredness, school problems, morning headache, thirstiness in the morning, oral breathing and nasal stuffiness) and night-time symptoms (habitual snoring, restless sleep and nightmares measured by questionnaire). Statistically significant differences in the following results were found: reduction of the apnoea-hypopnoea index measured by polysomnography (RR 0.39, 95% CI 0.20 to 0.76); daytime symptoms measured by questionnaire: oral breathing (RR 0.16, 95% CI 0.04 to 0.59,) and nasal stuffiness (RR 0.18, 95% CI 0.05 to 0.69); and night-time symptoms measured by questionnaire: habitual snoring (RR 0.18, 95% CI 0.06 to 0.55), and restless sleep (RR 0.21, 95% CI 0.05 to 0.84).

Comment: The quality of evidence is downgraded by study limitations (lack of allocation concealment and blinding) and by imprecise results (few patients).

    References

    • Carvalho FR, Lentini-Oliveira DA, Prado LB et al. Oral appliances and functional orthopaedic appliances for obstructive sleep apnoea in children. Cochrane Database Syst Rev 2016;(10):CD005520. [PubMed].

Primary/Secondary Keywords