ORAL APPLIANCES TREATING SLEEP APNEA REDUCE BLOOD PRESSURE SIMILAR TO CPAP.

WELL IT IS WELL ESTABLISHED THAT ORAL APPLIANCES ARE EFFECTIVE IN TREATING SLEEP APNEA AND SNORING THIS ARTICLE SHOWS IT ALSO REDUCES BLOOD PRESSURE SIMILAR TO CPAP TREATMENT.

HEAVY SNORING HAS BEEN SHOWN TO INCREASE CAROTID ATHEROSCLEROSIS DUE TO VIBRATIONS. THIS IS ALSO WELL TREATED BY ORAL APPLIANCE THERAPY.

IF SLEEP APNEA IS ELIMINATED THAN THE DISORDERS RELATED TO THE DISORDER WILL ALSO BE ELIMINATED. I EXPECT THAT RESEARCH WILL CONTINUE TO SHOW THAT ORAL APPLIANCES ARE EQUAL TO CPAP WHEN SLEEP APNEA IS SUCCESSFULLY TREATED.

BECAUSE 60% OF PATIENTS ABANDON CPAP IT IS INEFFECTIVE FOR THOSE PATIENTS. SIMPLY STATED CPAP DOES NOT SUCCESSFULLY TREAT ANY DISORDERS IN THE 60% OF PATIENT WHO DO NOT USE IT.

WHAT IS THE BEST SLEEP APNEA TREATMENT? THE BEST SLEEP APNEA TREATMENT IS BOTH EFFECTIVE AND IS USED BY PATIENTS.

THE BEST TREATMENT WILL ALWAYS BE A TREATMENT THAT IS USED BY THE PATIENT. COMFORTABLE ORAL APPLIANCES ARE PREFERRED OVER CPAP BY MOST PATIENTS OFFERED A CHOICE.

Sleep. 2004 Aug 1;27(5):934-41.
Oral appliance therapy reduces blood pressure in obstructive sleep apnea: a randomized, controlled trial.

Gotsopoulos H, Kelly JJ, Cistulli PA.
Department of Respiratory & Sleep Medicine, St George Hospital, The University of New South Wales, Sydney Australia.
Comment in:
Sleep. 2004 Aug 1;27(5):842-3.

Abstract

STUDY OBJECTIVE: To investigate the short-term effect (4 weeks) of oral appliance therapy for obstructive sleep apnea on blood pressure.
DESIGN: Randomized, controlled, crossover trial.
SETTING: Multidisciplinary sleep disorders clinic in a university teaching hospital.
PATIENTS: Sixty-one patients diagnosed with obstructive sleep apnea on polysomnography (apnea hypopnea index > or = 10 per hour and at least 2 of the following symptoms--daytime sleepiness, snoring, witnessed apneas, fragmented sleep; age > 20 years; and minimum mandibular protrusion of 3 mm).
INTERVENTION: A mandibular advancement splint (MAS) and control oral appliance for 4 weeks each.
MEASUREMENTS AND RESULTS: Polysomnography and 24-hour ambulatory blood pressure monitoring were carried out at baseline and following each 4-week intervention period. Patients showed a 50% reduction in mean apnea hypopnea index with MAS compared with the control and a significant improvement in both minimum oxygen saturation and arousal index. There was a significant reduction with the MAS in mean (+/- SEM) 24-hour diastolic blood pressure (1.8 +/- 0.5 mmHg) compared with the control (P = .001) but not in 24-hour systolic blood pressure. Awake blood-pressure variables were reduced with the MAS by an estimated mean (+/- SEM) of 3.3 +/- 1.1 mmHg for systolic blood pressure (P = .003) and 3.4 +/- 0.9 mmHg for diastolic blood pressure (P < .0001). There was no significant difference in blood pressure measured asleep.
CONCLUSION: 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.