{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:00:39Z","timestamp":1790622039388,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Obstructive sleep apnea contributes to cardiovascular morbidity, and its treatment may mitigate this risk. Continuous positive airway pressure and mandibular advancement devices are established therapies, but their comparative cardiometabolic effects remain uncertain. We conducted a systematic review and meta\u2010analysis of randomised controlled trials from multiple major databases through May 2024, pooling dichotomous outcomes as risk ratios and continuous outcomes as mean differences with 95% confidence intervals using StataMP version 17. Across 14 randomised trials including 1241 patients, CPAP showed clear advantages over MAD. CPAP significantly reduced low\u2010density lipoprotein (MD \u221215.20\u2009mg\/dL; 95% CI \u221228.86 to \u22121.53), total cholesterol (MD \u221217.10\u2009mg\/dL; 95% CI \u221230.15 to \u22124.05) and dipping diastolic blood pressure (MD \u22123.12\u2009mmHg; 95% CI \u22125.62 to \u22120.62). No meaningful differences emerged between the two therapies for serum glucose, HDL, triglycerides, 24\u2010h mean blood pressure, systolic or diastolic pressures during sleep or wakefulness, or heart rate metrics. Overall, CPAP demonstrated superior lipid and diastolic blood pressure improvement compared with MAD, pointing towards a more favourable cardiometabolic profile. Both interventions remain effective treatments for OSA, yet CPAP may provide added benefit in reducing cardiovascular risk factors and appears to be the preferred modality in patients with elevated cardiometabolic risk.<\/jats:p>","DOI":"10.1111\/jsr.70351","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T14:00:46Z","timestamp":1782309646000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Continuous Positive Airway Pressure Versus Mandibular Advancement Devices Impact on Cardio\u2010Metabolic Outcomes in Patients With Obstructive Sleep Apnea: A Systematic Review and Meta\u2010Analysis of Randomised Controlled Trials"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6266-4991","authenticated-orcid":false,"given":"AlMothana","family":"Manasrah","sequence":"first","affiliation":[{"name":"Department of Pulmonology and Critical Care United Health Services\u2014Wilson Medical Center  Johnson City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Tanashat","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Yarmouk University  Irbid Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramy","family":"Ghaly","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Missouri\u2014Kansas City  Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8917-671X","authenticated-orcid":false,"given":"Mohamed","family":"Abouzid","sequence":"additional","affiliation":[{"name":"Department of Physical Pharmacy and Pharmacokinetics Poznan University of Medical Sciences  Poznan Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6776-883X","authenticated-orcid":false,"given":"Shrouq","family":"Ramadan","sequence":"additional","affiliation":[{"name":"Internal Medicine Department Ain Shams University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdo\u2010rhman","family":"Khassawneh","sequence":"additional","affiliation":[{"name":"Internal Medicine Department Henry Ford Macomb Hospital  Clinton Twp Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6650-6982","authenticated-orcid":false,"given":"Abubakar","family":"Nazir","sequence":"additional","affiliation":[{"name":"Internal Medicine Department King Edward Medical University  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaid","family":"Bataineh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Jordan University of Science and Technology  Irbid Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9772-2365","authenticated-orcid":false,"given":"Mohammed","family":"Ayyad","sequence":"additional","affiliation":[{"name":"Department of Medicine Rutgers New Jersey Medical School  Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2514-0689","authenticated-orcid":false,"given":"Mohamed","family":"Abuelazm","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Tanta University  Tanta Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2919-6196","authenticated-orcid":false,"given":"Basel","family":"Abdelazeem","sequence":"additional","affiliation":[{"name":"Cardiology Department West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Imran","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Pulmonology and Critical Care United Health Services\u2014Wilson Medical Center  Johnson City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-021-04064-7"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200311-1571OC"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.12.18"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.16303"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-014-0937-5"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.7980"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.23747"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-020-02183-1"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s41030-020-00137-2"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-015-1265-0"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.8822"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119536604"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100145517"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2006.063644"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2020.03.015"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0245392"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2024.03.359"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/life13020296"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.7640"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201212-2223OC"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.4858"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.6061\/clinics\/2013(08)17"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-017-1590-6"},{"issue":"6","key":"e_1_2_13_26_1","first-page":"S47","article-title":"Mechanisms of the Effectiveness of Continuous Positive Airway Pressure in Obstructive Sleep Apnea","volume":"15","author":"S\u00e9ri\u00e8s F.","year":"1992","journal-title":"Sleep"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsab015"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-014-0945-5"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-019-03175-6"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.9908"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.9308"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00380-019-01392-3"}],"container-title":["Journal of Sleep Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jsr.70351","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jsr.70351","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jsr.70351","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:12:31Z","timestamp":1790619151000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jsr.70351"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,24]]},"references-count":31,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/jsr.70351"],"URL":"https:\/\/doi.org\/10.1111\/jsr.70351","archive":["Portico"],"relation":{},"ISSN":["0962-1105","1365-2869"],"issn-type":[{"value":"0962-1105","type":"print"},{"value":"1365-2869","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,24]]},"assertion":[{"value":"2025-05-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70351"}}