The title doesn't really reflect what's accurately explained in the article: the study was solely about comparing blood pressure reduction rates in the mouthguard vs. CPAP groups, as opposed to the more common metric of whether breathing actually stopped. There was greater reduction in BP in the mouthguard group, and the hypothesis is just that participants simply wore them more when sleeping.
But the article also explicitly stated "MADs are less intrusive, but studies have shown they’re outperformed by CPAP when it comes to the apnea-hypopnea index (AHI), the number of times airflow fully (apnea) or partially (hypopnea) stops per hour during sleep."
About “the hypothesis is just that participants simply wore them more when sleeping” - we know that was the case:
> Over half (56.5%) assigned to the MAD used it for six or more hours each night on average over the study period, while 23.2% of CPAP users did the same.
> “The MAD patients simply used the device longer,” Chi-Hang said.
The takeaway is that if you can handle wearing the CPAP mask all night, then that's your best option. If you can't, then you may be able to obtain better results with the the MAD.
I know some people struggle to get used to CPAP but I found I had fully adjusted to sleeping with the mask on all night after about 2 weeks. Huge difference in energy levels and blood pressure.
Yep, to clarify I didn't word my statement well. We know it's the case that participants wore the MAD more. The hypothesis is that the reason for the greater reduction in BP for MAD users is solely due to this difference in adherence.
The title on HN is the literal title of the article.
As Op stated, initially in the article the author clearly states that CPAP is preferred and most effective in totality.
The actual point of the article is that Obstructive Sleep Apnea is under-diagnosed, causes hypertension, and the conventional treatment kinda sucks—and mouth guards should be the offered as an alternative treatment because it is effective at reducing blood pressure.
The title isn’t misleading per-se, but you do have to have the article.
Whether or not the title on HN matches the article is a separate question from whether the article has a misleading title imo. I don’t see how a treatment could be “just as effective” if it has a lower AHI, unless we are saying there’s some other metric which really matters. But there’s a pretty clear contradiction between the body and title of the article.
What to do about articles which are misleading in this way is another question. Removing articles whose title is contradicted by the article is a bit heavy handed I think. It should ideally count against the reputation of the website, but there are too many for me to keep track of.
But the article also explicitly stated "MADs are less intrusive, but studies have shown they’re outperformed by CPAP when it comes to the apnea-hypopnea index (AHI), the number of times airflow fully (apnea) or partially (hypopnea) stops per hour during sleep."