The effect of oral appliance therapy on blood pressure in patients with obstructive sleep apnea

• Published in: Sleep & breathing Vol. 10; no. 1; pp. 29 - 36
• Main Authors: OTSUKA, Ryo, RIBEIRO DE ALMEIDA, Fernanda, LOWE, Alan A, LINDEN, Wolfgang, RYAN, Frank
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.03.2006; Springer Nature B.V
• Subjects: Activator Appliances; Adult; Aged; Antihypertensive Agents - therapeutic use; Biological and medical sciences; Blood pressure; Blood Pressure Monitoring, Ambulatory - methods; Body Mass Index; Cerebrospinal fluid. Meninges. Spinal cord; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Female; Fundamental and applied biological sciences. Psychology; Health Status; Humans; Hypertension; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - epidemiology; Male; Mandible - physiology; Medical sciences; Middle Aged; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Nervous system (semeiology, syndromes); Neurology; Severity of Illness Index; Sleep apnea; Sleep Apnea Syndromes - diagnosis; Sleep Apnea Syndromes - epidemiology; Sleep Apnea, Obstructive - epidemiology; Sleep Apnea, Obstructive - therapy; Sleep disorders; Sleep. Vigilance; Studies; Vertebrates: nervous system and sense organs; Jaw; Systolic pressure; Mandibular advancement; Diastolic pressure; Blood pressure monitoring; Sleep apnea; Positive pressure; Arterial pressure; Blood pressure; Sleep wake cycle; Ambulatory; Pretreatment; Neurological disorder; Obstructive; Monitoring; Human; Cartography; Sleep apnea syndrome; Nervous system diseases; Respiratory disease; Oral administration; Sleep disorder; Arterial blood; Sleep; Treatment; Hemodynamics
• ISSN: 1520-9512; 1522-1709
• DOI: 10.1007/s11325-005-0038-6

The objective of the study was to investigate the effects of oral appliance (OA) therapy on ambulatory blood pressure in patients with obstructive sleep apnea (OSA). Eleven OSA patients who received OA therapy were prospectively investigated. Ambulatory blood pressure was measured for 20 h from 4:00 P.M.: to 12:00 noon the next day using an ambulatory blood pressure monitor. The Respiratory Disturbance Index (RDI) was measured in the pretreatment and posttitration periods. The OA was titrated to reach a therapeutic jaw position over 2 to 8 months, and posttitration measurements were repeated. At posttitration, the RDI was significantly decreased from a mean (SD) of 24.7 (20.1) to 6.1 (4.5). Significant reductions in diastolic blood pressure (DBP) and mean arterial pressure (MAP) were found for the 20-h periods, and systolic blood pressure (SBP), DBP, and MAP while asleep. The mean values were 79.5 (5.5) to 74.6 (6.0) for DBP and 95.9 (5.4) to 91.2 (5.9) for MAP, for over a 20-h period, and 118.4 (10.0) to 113.7 (9.1) for SBP, 71.6 (8.0) to 67.2 (7.9) for DBP, and 88.4 (8.0) to 83.9 (7.5) for MAP, while asleep. This study suggests that successful OSA treatment with an OA may also be beneficial to lower blood pressure in OSA patients, as previously suggested for nasal continuous positive airway pressure therapy.