Oral Appliance Therapy Reduces Blood Pressure in Obstructive Sleep Apnea: a Randomized, Controlled Trial

Abstract

Oral appliance therapy for obstructive sleep apnea over 4 weeks results in a reduction in blood pressure, similar to that reported with continuous positive airway pressure therapy.

Effects of mandibular advancement on brain activation during inspiratory loading in healthy subjects: a functional magnetic resonance imaging study

“…Several studies have reported a reduction in nocturnal cardiac ischemic episodes and an improvement in daytime blood pressure levels and left ventricular function with long-term nasal CPAP (nCPAP) treatment (30,54). Furthermore, it has been shown that the treatment of OSA with an OA results in a significant reduction in hypertension (18), which is similar to that reported with nCPAP. Therefore, the deactivation of the cingulate cortex observed in this study may be related to changes in autonomic activity in association with mandibular advancement.…”

“…Although the cause-and-effect relationship between anatomical and functional deficiencies has not been determined, the examination of neural sites that characterize OSA may reveal the neurogenic nature and/or consequences of the disorder (19). It should be noted that the pathological background of OSA is not straightforward, rather there is the variability in signs and symptoms and effectiveness of treatment alternatives (e.g., CPAP, OA), according to factors that included the severity of the disease, obesity, and gender (1,17,18,23,40,42). Thus, for better understanding of the possible interaction between neural deficits and responses to the OA for a wide spectrum of OSA, it would be necessary to collect the baseline knowledge regarding mandibular advancement in healthy subjects.…”

Avanços recentes do impacto da apneia obstrutiva do sono na hipertensão arterial sistêmica

“…As regards alternative treatments of OSA, the use of mandibular advancement devices, which pull the mandible forward and, consequently, the base of the tongue, has proved efficient in reducing blood pressure and should be considered an alternative treatment for patients not complying with CPAP or those with mild/moderate OSA 70,71 .…”

Nocturnal Blood Pressure Is Reduced by a Mandibular Advancement Device for Sleep Apnea in Women: Findings From Secondary Analyses of a Randomized Trial

“…Three trials reported no effect versus placebo,3, 5, 6 one study reported a reduction in daytime blood pressure,7 and another reported a reduction in nocturnal diastolic blood pressure 4. The sixth study reported no difference between a mandibular advancement device and continuous positive airway pressure, but there was no difference in blood pressures versus baseline with either treatment 8.…”

“…We identified 6 randomized controlled trials using mandibular advancement devices for sleep apnea with 24‐hour blood pressure as the outcome 3, 4, 5, 6, 7, 8. Three trials reported no effect versus placebo,3, 5, 6 one study reported a reduction in daytime blood pressure,7 and another reported a reduction in nocturnal diastolic blood pressure 4.…”