Summary of findings 5. Myofunctional therapy compared to respiratory exercises + nasal dilator strip for obstructive sleep apnoea.
| Myofunctional therapy compared to respiratory exercises + nasal dilator strip for obstructive sleep apnoea | ||||||
| Patient or population: Obstructive sleep apnoea Setting: Outpatient Intervention: Myofunctional therapy Comparison: Respiratory exercises + nasal dilator strip | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with respiratory exercises + nasal dilator strip | Risk with Myofunctional therapy | |||||
| Daytime sleepiness (ESS): endpoint score. Follow‐up: 3 months. | The mean ESS endpoint score was 8.7 | MD 0.2 higher (2.46 lower to 2.86 higher) | ‐ | 58 (1 RCT) | ⊕⊕⊝⊝ LOW1 2 | May result in little to no difference in daytime sleepiness. Scores from 0 to 24. Lower scores denote lower daytime sleepiness. MCID 3 points. |
| Sleep quality (PSQI): endpoint score. Follow‐up: 3 months. | The mean PSQI endpoint score was 6.2 | MD 1.94 lower (3.17 lower to 0.72 lower) | ‐ | 97 (2 RCTs) | ⊕⊕⊕⊝ MODERATE 1 | Probably increases sleep quality slightly. Scores from 0 to 21. Lower scores denote a healthier sleep quality. MCID 3 points. |
| AHI: endpoint score. Follow‐up: 3 months. | The mean AHI endpoint score was 18.8 events/hour | MD 3.8 events/hour lower (9.05 lower to 1.45 higher) | ‐ | 58 (1 RCT) | ⊕⊕⊝⊝ LOW1 2 | May result in little to no difference in AHI. Events per hour. Lower scores better. MCID 5 points. |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). AHI: apnoea hypopnoea index; CI: Confidence interval; ESS: Epworth sleepiness scale; MD: mean difference; MCID: Minimal Clinically Important Diference; PSQI: Pittsburgh Sleep Quality Index | ||||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
1 Downgraded one point for unblinded
2 Downgraded one point for imprecision