Oral Appliance Therapy
Oral appliance therapy
reduces blood pressure in obstructive sleep
apnea: a randomized, controlled trial.
Gotsopoulos H, Kelly JJ,
Department of Respiratory & Sleep Medicine,
St George Hospital, The University of New
South Wales, Sydney Australia.
Sleep. 2004 Aug 1;27(5):842-3.
STUDY OBJECTIVE: To
investigate the short-term effect (4 weeks)
of oral appliance therapy for obstructive
sleep apnea on blood pressure.
controlled, crossover trial.
sleep disorders clinic in a university
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
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.
PMID: 15453552 [PubMed - indexed for
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