TABLE 1.
Patient, intervention, comparison, outcome (PICO) questions
| Question | Population | Intervention | Comparison | Outcome | Recommendation | |
| PICO 1 | In adult obese patients with OSA, should laparoscopic RYGB surgery or weight-reducing diet be used? | Obese patients with OSA | Laparoscopic RYGB surgery | Weight-reducing diet | AHI; sleep efficiency; health-related quality of life; sleepiness; hypertension; compliance; adverse events | Conditional recommendation for the intervention, very low quality of evidence |
| PICO 2 | Should a custom-made dual-block mandibular advancement device or CPAP be used for adult patients with OSA? | Adult patients with OSA | Custom-made dual-block mandibular advancement device | CPAP | AHI; sleep efficiency; oxygen desaturation; sleepiness; physical functioning; arterial hypertension; compliance; adverse events | Conditional recommendation against the intervention, very low quality of evidence |
| PICO 3 | Should hypoglossal nerve stimulation during sleep or no treatment be used for adult patients with OSA? | Adult patients with OSA | Hypoglossal nerve stimulation | No treatment | AHI; sleep efficiency; oxygen desaturation; sleepiness; physical functioning; arterial hypertension; compliance; adverse events | Conditional recommendation against the intervention, very low quality of evidence |
| PICO 4a | In adult patients with OSA, should myofunctional therapy or no treatment be used? | Adult patients with OSA | Myofunctional therapy | No treatment | AHI; sleep efficiency; sleepiness; physical functioning; compliance; adverse events | Conditional recommendation for either the intervention or the comparison, low quality of evidence |
| PICO 4b | Should myofunctional therapy or CPAP be used for adult patients with OSA? | Adult patients with OSA | Myofunctional therapy | CPAP | AHI; sleep efficiency; sleepiness; physical functioning; compliance; adverse events | Conditional recommendation against the intervention, low quality of evidence |
| PICO 5 | Should maxillo-mandibular osteotomy or CPAP be used for adult patients with OSA? | Adult patients with OSA | Maxillo-mandibular osteotomy | CPAP | AHI; sleepiness; satisfaction; adverse events | Conditional recommendation for either the intervention or the comparison, very low quality of evidence |
| PICO 6 | Should carbonic anhydrase inhibitors (compared to placebo) be used for adult patients with OSA? | Adult patients with OSA | Carbonic anhydrase inhibitors | Placebo | AHI; sleep efficiency; oxygen desaturation; sleepiness; arterial hypertension; compliance; adverse events | Conditional recommendation for the intervention, low quality of evidence |
| PICO 7 | Should positional therapy or CPAP be used for adult patients with position-dependent OSA? | Adult patients with position-dependent OSA | Positional therapy | CPAP | AHI; sleep efficiency; oxygen desaturation; sleepiness; health-related quality of life; energy level scores; compliance; adverse events | Conditional recommendation for either the intervention or the comparison, very low certainty of evidence |
| PICO 8 | Should positional therapy (intervention) or custom made dual-block mandibular advancement devices (control) be used for adult patients with position-dependent OSA? | Adult patients with position-dependent OSA | Positional therapy | Custom-made dual-block mandibular advancement device | AHI; sleep efficiency; oxygen desaturation; sleepiness; arterial hypertension; adherence; adverse events; quality of life | Conditional recommendation for either the intervention or the comparison, very low certainty of evidence |
OSA: obstructive sleep apnoea; RYGB: Roux-en-Y gastric bypass; AHI: apnoea–hypopnoea index; CPAP: continuous positive airway pressure.