The effect of oral appliance therapy on blood pressure in patients with obstructive sleep apnea
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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.
KeywordsBlood pressure monitoring Ambulatory Sleep apnea Obstructive Mandibular advancement
The authors are indebted to Mrs. Ingrid Ellis for her editorial assistance and to Mrs. Mary Wong for her statistical analysis assistance. The authors would like to thank Ms. Y. Erskine and Ms. J. Leclerc, Research Co-ordinators, Behavioural Cardiology, Department of Psychology at The University of British Columbia for their assistance and advice on the ambulatory blood pressure monitoring device used. Klearway was invented by Dr. Alan A. Lowe at The University of British Columbia. International patents have been obtained by The University of British Columbia, and specific licensees are assigned the rights to manufacture and distribute the appliance worldwide. Royalties from the sale of Klearway are paid to The University of British Columbia.
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