InquiryEffects of treatment on blood pressure
Section snippets
Background
Obstructive sleep apnea (OSA) is a chronic inflammatory disease characterized by repetitive blood oxygen desaturation, cortical micro-arousal, and negative thoracic pressure on the heart. An estimated 25 million adults in the United States suffer from OSA, with a higher prevalence among older adults. With the increased numbers of obese and older patients worldwide, OSA’s prevalence is expected to rise. The most common treatments are continuous positive airway pressure (CPAP) as a first line of
Study Results
The recent study indicates that the effect of MAS on blood pressure in OSA patients is equipotent with that of CPAP, supporting its use for patients with mild to moderate OSA and/or intolerance to CPAP. Both treatments had similar effects on diastolic blood pressure, but CPAP had the strongest association with systolic blood pressure reduction. The apnea-hypopnea index and oxygen desaturation index were lower with MAS than CPAP, but the difference was not statistically significant. No
Analysis
This study’s findings were in contrast to a meta-analysis published in 2013. However, the current paper covered 51 studies compared to just 7 in the earlier paper and used network meta-analysis for the comparison. CPAP and MAS have also been compared for their effect on daytime sleepiness. Both reduced sleepiness but the effect was more important with CPAP therapy in severe OSA or greater daytime sleepiness.
Overall the evidence supports using MAS to manage some patients with OAS and is
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Huynh NT: Mandibular advancement splints decrease blood pressure similarly as with continuous positive airway pressure in sleep apnea. Oral Dis 22:348-349, 2016
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