TABLE 1

Patient, intervention, comparison, outcome (PICO) questions

QuestionPopulationInterventionComparisonOutcomeRecommendation
PICO 1In adult obese patients with OSA, should laparoscopic RYGB surgery or weight-reducing diet be used?Obese patients with OSALaparoscopic RYGB surgeryWeight-reducing dietAHI; sleep efficiency; health-related quality of life; sleepiness; hypertension; compliance; adverse eventsConditional recommendation for the intervention, very low quality of evidence
PICO 2Should a custom-made dual-block mandibular advancement device or CPAP be used for adult patients with OSA?Adult patients with OSACustom-made dual-block mandibular advancement deviceCPAPAHI; sleep efficiency; oxygen desaturation; sleepiness; physical functioning; arterial hypertension; compliance; adverse eventsConditional recommendation against the intervention, very low quality of evidence
PICO 3Should hypoglossal nerve stimulation during sleep or no treatment be used for adult patients with OSA?Adult patients with OSAHypoglossal nerve stimulationNo treatmentAHI; sleep efficiency; oxygen desaturation; sleepiness; physical functioning; arterial hypertension; compliance; adverse eventsConditional recommendation against the intervention, very low quality of evidence
PICO 4aIn adult patients with OSA, should myofunctional therapy or no treatment be used?Adult patients with OSAMyofunctional therapyNo treatmentAHI; sleep efficiency; sleepiness; physical functioning; compliance; adverse eventsConditional recommendation for either the intervention or the comparison, low quality of evidence
PICO 4bShould myofunctional therapy or CPAP be used for adult patients with OSA?Adult patients with OSAMyofunctional therapyCPAPAHI; sleep efficiency; sleepiness; physical functioning; compliance; adverse eventsConditional recommendation against the intervention, low quality of evidence
PICO 5Should maxillo-mandibular osteotomy or CPAP be used for adult patients with OSA?Adult patients with OSAMaxillo-mandibular osteotomyCPAPAHI; sleepiness; satisfaction; adverse eventsConditional recommendation for either the intervention or the comparison, very low quality of evidence
PICO 6Should carbonic anhydrase inhibitors (compared to placebo) be used for adult patients with OSA?Adult patients with OSACarbonic anhydrase inhibitorsPlaceboAHI; sleep efficiency; oxygen desaturation; sleepiness; arterial hypertension; compliance; adverse eventsConditional recommendation for the intervention, low quality of evidence
PICO 7Should positional therapy or CPAP be used for adult patients with position-dependent OSA?Adult patients with position-dependent OSAPositional therapyCPAPAHI; sleep efficiency; oxygen desaturation; sleepiness; health-related quality of life; energy level scores; compliance; adverse eventsConditional recommendation for either the intervention or the comparison, very low certainty of evidence
PICO 8Should 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 OSAPositional therapyCustom-made dual-block mandibular advancement deviceAHI; sleep efficiency; oxygen desaturation; sleepiness; arterial hypertension; adherence; adverse events; quality of lifeConditional 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.