TABLE VIII.C.2.a.

Summary of evidence for mandibular repositioning device efficacy versus CPAP

Study	Year	LOE (1a–5)	Study design	Study groups	Clinical endpoint	Conclusion
Bratton et al.1380	2015a	1a	Network meta-analysis	1. MRD 2. CPAP 3. Control 67 Studies6873 Subjects	Epworth Sleepiness Score	CPAP more effective than MRD in reducing ESS (although possibility of publication bias in favor of CPAP that may contribute to difference)
Bratton et al.1208	2015b	1a	Network meta-analysis	1. MRD 2. CPAP 3. Control 51 Studies4888 Subjects	Blood pressure	Both MRD and CPAP reduce BP relative to control. There was no difference in BP reduction between CPAP and MRD
Kuhn et al.1381	2017	1a	Systematic review and meta-analysis	1. MRD 2. CPAP 23 Studies2342 Subjects	SF-36 (mental and physical components)	Suggestive that MRD may be similarly effective to CPAP, but more RCTs needed
Ramar et al.809	2015	1a	Clinical practice guideline	1. MRD 2. CPAP 15 Studies491 Subjects	Polysomnographic indices, adherence, side effects, blood pressure, quality of life, sleepiness	It is recommended that MRD is prescribed for adult OSA patients, rather than no therapy, who are intolerant of CPAP or prefer alternative therapy
Schwarz et al.1385	2018	1a	Systematic review and meta-analysis	1. CPAP 2. MAS 12 (824) [AHI]Six (525) [compliance]Four (559) [FOSQ]10 (950) [ESS]Two (244) [cognitive function]	1. AHI 2. Compliance 3. FOSQ 4. ESS 5. Cognitive function	CPAP better reducing AHI. No difference SF-36, FOSQ, cognitive performance. ESS potentially favors CPAP, adherence greater in MRD

Abbreviations: AHI, apnea hyponea index; BP, blood pressure; CPAP, continuous positive airway pressure; ESS, Epworth Sleepiness Score; FOSQ, Functional Outcomes of Sleep Questionnaire; MRD, mandibular repositioning.