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Table 1 CPAP versus surgery comparisons

From: Reconsidering first-line treatment for obstructive sleep apnea: a systematic review of the literature

First author - year EBM rating Study design Treatment groups Study findings Study limitations/issues
Woodson 2003 1 RCT nCPAP vs. RFTR vs. sham RFTR Relative to sham Rx, rxn time & fastest rxn time both improved post-RFTR (p = 0.03 & 0.02) but not on CPAP. Very poor CPAP complance (~16 h/week);
ESS ↓ similarly with RFTR & CPAP (−2.1 vs. −2.3, p = 0.005 & 0.02). SNORE25 score ↓ w/both (p < 0.001 vs. 0.005) Different # of Rx sessions in RFTR (4.5) vs. sham RFTR (2.9) groups
Ceylan 2009 3 nonRCT TC-RFTR vs. nCPAP Both RFTR & CPAP → ↓AHI (28.5 → 15.7 vs 29.6 → 16.1, both p < 0.001; NS); ↓ESS (11.1 → 8.4, p = 0.003 vs 10.8 → 8.2, p = 0.003; NS); Non-random allocation to Rx/potential selection bias;
↓CT90 (15.2 → 11.1 % vs 14.3 → 10.7 %, both p < 0.001; NS); & ↑LSAT (88.4 → 93.5, p = 0.03 vs 86.8 → 94.6 %, p < 0.001, NS). 53.8 vs. 52.4 % responders Compliance with CPAP not reported
Weaver 2004 1 pop. survey UPPP ± TE ± SP ± other vs. CPAP 1339/18,754 (7.1 %) died w/ CPAP vs. 71/2072 (3.4 %) post-op. Adjusting for age, gender, race, year of Rx & co-morbidities, Retrospective analysis; potential confounders missing
MR ↑ 31 % (95 % CI 3–67 %) w/CPAP (p = 0.03) (e.g., severity of OSA, overall health status)