Mandibular Devices Work for Lowering Sleep Apnea BP
Written by Editor   
Wednesday, February 10, 2016 12:00 AM

Both CPAP and MAD are effective for sleep apnea.

Mandibular advancement devices are almost as effective as continuous positive airway pressure (CPAP) for lowering blood pressure in patients with obstructive sleep apnea, according to a systematic review and meta-analysis.

The analysis showed slightly greater systolic and diastolic blood pressure (BP) reductions in patients treated with CPAP, but the difference was not statistically significant.

CPAP has a proven track record for improving symptoms associated with sleep apnea, including hypertension, but compliance with the nasal mask treatment is poor. Mouth guard-like mandibular advancement devices (MADs), which open the airways by moving the lower jaw forward, tend to be better tolerated, but their impact on blood pressure has not been well studied.

Research analysis of 51 randomized studies with 4,888 patients mostly included trials comparing CPAP with an inactive control (44 studies). Three studies compared MADs with an inactive control, one trial compared CPAP with MAD (126 patients), and three compared CPAP, MADs, and an inactive control (244 patients).

The authors reported that compared with inactive control, CPAP use was associated with a reduction in systolic blood pressure (SBP) of 2.5 mmHg and in diastolic blood pressure (DBP) of 2.0 mmHg.

Also, a 1-hour-per-night increase in mean CPAP use was associated with an additional drop in SBP of 1.5 mmHg and an additional reduction in DBP of 0.9 mmHg.

Compared with an inactive control, MADs were associated with a reduction in SBP of 2.1 mmHg and in DBP of 1.9 mmHg.

No significant difference was seen between CPAP and MADs in change in systolic or diastolic blood pressure.