Comparison of the effects of continuous positive airway pressure and mandibular advancement devices on sleepiness in patients with obstructive sleep apnoea: a network meta-analysis

2015 ◽  
Vol 3 (11) ◽  
pp. 869-878 ◽  
Author(s):  
Daniel J Bratton ◽  
Thomas Gaisl ◽  
Christian Schlatzer ◽  
Malcolm Kohler
Author(s):  
K Chaidas ◽  
A Ashman

Abstract Objectives This study aimed to review the funding policies of clinical commissioning groups for treatment of obstructive sleep apnoea in England. Methods Published policies from a randomly selected sample of 60 out of 190 clinical commissioning groups were reviewed. Results Continuous positive airway pressure was funded based on a clinical assessment or according to criteria that were in line with national guidelines in most clinical commissioning groups (49 of 60), with 11 clinical commissioning groups offering no policy. Mandibular advancement devices, tonsillectomy and nasal surgery were funded based on a clinical assessment or certain criteria in 16, 25 and 16 clinical commissioning groups, respectively. In contrast, only one clinical commissioning group provided funding for soft palate, tongue base or mandibular surgery. Hypoglossal nerve stimulation was not mentioned in any clinical commissioning group's policy. Conclusion Although most clinical commissioning groups provide funding for the use of continuous positive airway pressure, the availability of funding for other obstructive sleep apnoea treatment modalities is heterogeneous, leaving continuous positive airway pressure intolerant patients with limited therapeutic options in some regions.


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