The effectiveness of mandibular advancement devices

The effectiveness of mandibular advancement devices in reducing blood pressure.

On this occasion, Dr. Pedro Mayoral makes a brief comment about the study of Sekizuka, H., Osada, N., and Akashi, YJ (2016) on the effectiveness of AMD in the treatment of snoring and OSAS, and their relationship with blood pressure.

 

Studies found relationship between OA and reduction of blood pressure

Studies found relationship between OA and reduction of blood pressure

A recently published article has demonstrated the effectiveness of mandibular advancement devices such as Orthoapnea in the treatment of snoring and sleep apnea and its effectiveness in reducing blood pressure.

The study of Sekizuka, H., Osada, N., & Akashi, Y. J. (2016). Effect of oral appliance therapy on blood pressure in Japanese patients with obstructive sleep apnea.Clinical and Experimental Hypertension, 1-5. published in the journal Clinical & Experimental Hypertension has shown the reduction of hypertension in all 237 patients treated with device.

Treatment with oral device reduced both diastolic and systolic blood pressure (SBP) -2.4 ± 14.8 (p = 0.078) as well as BP diastolic (DBP) -2.0 ± 11.7 mm Hg (p = 0.045) in ALL PATIENTS.

Abstract

OBJECTIVE:

Obstructive sleep apnea (OSA) treatment in patients with OSA and hypertension reduces blood pressure (BP). Oral appliance (OA) therapy is nowadays prescribed for patients with mild to moderate OSA. This study aimed to clarify the effect of OA therapy on BP reduction in Japanese patients with mild to moderate OSA.

METHODS:

Polysomnography was employed to detect sleep-disordered breathing. Totally, 237 patients without cardiac and/or cerebrovascular diseases and those with apnea-hypopnea index (AHI) ≥ 5/h-< 30/h were enrolled. Office BP change after receiving 8-12 weeks of OA therapy was assessed and the factors related to the degree of BP reduction were analyzed.

RESULTS:

The study patients consisted of 188 men and 49 women, the mean age was 54.7 ± 13.2 years old, and the body mass index (BMI) was 24.6 ± 3.4 kg/m(2). The antihypertensive effect of OA therapy resulted in systolic BP (SBP) -2.4 ± 14.8 (p = 0.078) and diastolic BP (DBP) -2.0 ± 11.7 mm Hg (p = 0.045) in all patients. SBP before OA therapy played a significant role in the degree of SBP reduction (β = -0.597, p < 0.001), whereas DBP before OA therapy was a significant factor of the degree of DBP reduction (β = -0.522, p < 0.001).

CONCLUSION:

A certain time period of OA therapy effected BP reduction in mild to moderate OSA patients without cardiac and/or cerebrovascular diseases. Its antihypertensive effect was greater in OSA patients whose BP was higher before receiving OA therapy.

KEYWORDS:

Hypertension; mandibular advancement device; office blood pressure; polysomnography; sleep-disordered breathing

 

Source: Sekizuka, H., Osada, N., & Akashi, Y. J. (2016). Effect of oral appliance therapy on blood pressure in Japanese patients with obstructive sleep apnea.Clinical and Experimental Hypertension, 1-5.

Author: Dr. Pedro Mayoral.