Quality-of-life is an important health outcome, and has been demonstrated to improve with CPAP treatment. The effect of oral appliance therapy remains unclear from the existing limited literature. A study published in 2004 found that three months of oral appliance treatment improved the quality-of-life as measured by the Functional Outcomes of Sleep Questionnaire mean score and Short Form 36 (SF-36) overall health score compared to placebo tablet, with a similar effect to CPAP (26). In contrast, Engleman et al. (27) reported that CPAP was superior to oral appliance treatment in improving well-being more than three months, as assessed by the SF-36 scores for health transition and mental component (27). A long-term study evaluated quality-of-life in a randomized one-year follow-up of oral appliance treatment or uvulopalatopharyngoplasty (UPPP), and found that vitality, contentment, and sleep scores improved significantly in both groups, but the surgical group demonstrated significantly greater contentment than the oral appliance group (31). Placebo-controlled studies are needed to examine the long-term impact of oral appliance treatment on quality-of-life.
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