| Outcomes | No of Participants (studies) Follow up | Quality of the evidence (GRADE) | Relative effect (95 % CI) | Anticipated absolute effects | |
|---|---|---|---|---|---|
| Risk with Control | Risk difference with Mixed (SUP/EDU/BEH) Intervention + CPAP versus Usual Care + CPAP (95% CI) | ||||
|
CPAP Device Usage (hours/night) Higher is better |
4451 (10 studies) |
⊕⊝⊝⊝ due to risk of bias, inconsistency, imprecision, indirectness |
The mean CPAP device usage (hours/night) in the control group was 4.8 |
The mean CPAP device usage (hours/night) in the intervention groups was 0.82 higher (0.2 to 1.43 higher) | |
|
N deemed adherent (≥ four hours/night) Higher is better |
4015 (9 studies) |
⊕⊝⊝⊝ due to risk of bias, inconsistency, imprecision indirectness | RR 1.14 (1.04 to 1.26) | Moderate | |
| 656 per 1000 |
92 more per 1000 (from 26 more to 171 more) | ||||
| Withdrawal |
4956 (11 studies) |
⊕⊝⊝⊝ due to risk of bias, inconsistency, imprecision, indirectness | RR 0.64 (0.32 to 1.28) | Moderate | |
| 136 per 1000 |
49 fewer per 1000 (from 92 fewer to 38 more) | ||||
|
Quality of Life: Comparison of Change from Baseline Values - QoL: FOSQ-10 - Change from Baseline Higher is better |
176 (1 study) |
⊕⊝⊝⊝ due to risk of bias, indirectness, imprecision |
The mean quality of life: fosq-10 - in the control groups was −14.2 |
The mean quality of life: comparison of change from baseline values - QOL: FOSQ-10 - change from baseline in the intervention groups was 2.9 higher (0.52 lower to 6.32 higher) | |
|
Quality of Life: Comparison of Change from Baseline Values - QoL: SF-36 (PH) - Change from Baseline Higher is better |
2836 (1 study) |
⊕⊝⊝⊝ due to risk of bias, indirectness | The mean quality of life: sf-36 (ph) - in the control groups was 5.9 |
The mean quality of life: comparison of change from baseline values - QOL: sf-36 (ph) - change from baseline in the intervention groups was 5.7 higher (4.98 to 6.42 higher) | |
|
Quality of Life: Comparison of Values at Endpoint - QoL: FOSQ – Endpoint Scale from 5-20 Higher is better |
177 (1 study) |
⊕⊝⊝⊝ due to risk of bias, indirectness |
The mean quality of life: FOSQ - in the control groups was 16.7 |
The mean quality of life: comparison of values at endpoint - QOL: FOSQ - endpoint in the intervention groups was 0.3 higher (0.56 lower to 1.16 higher) | |
|
Quality of Life: Comparison of Values at Endpoint - QoL: SF-36 (PH) – Endpoint Scale from 0-100 Higher is better |
3014 (3 studies) |
⊕⊝⊝⊝ due to risk of bias, indirectness | The mean quality of life: sf-36 (ph) - in the control groups was 56.9 |
The mean quality of life: comparison of values at endpoint - QOL: sf-36 (ph) - endpoint in the intervention groups was 4.85 higher (2.49 to 7.21 higher) | |
|
Epworth Sleepiness Scale Score Scale from 0-24 Lower is better |
6388 (8 studies) |
⊕⊝⊝⊝ due to risk of bias, imprecision, indirectness | The mean ESS in the control group was 8.4 |
The mean epworth sleepiness scale score in the intervention groups was 1.32 lower* (2.48 to 0.16 lower) | |
| Mortality (critical outcome) | - | - | - | - | Not reported |
Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias
Downgraded by 1 or 2 increments for heterogeneity,unexplained by subgroup analysis. Random effect analysis used.
Downgraded by one increment if the confidence interval crossed one MID and downgraded by two increments if the confidence interval crossed both MIDs. MID for machine usage (adherence)- 1 hour; Established MIDs for SF-36 physical/mental- 2/3 ; FOSQ- 2 ; ESS −2.5; SAQLI – 2.. GRADE default MID (0.5XSD) used for all other continuous outcomes.
Downgraded by 1 or 2 increments because the majority of the evidence included an indirect or very indirect population respectively
Not sleepy in both groups.
From: Adherence
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