Clinical Report: Mandibular Advancement Device vs CPAP in Patients With Obstructive Sleep Apnea
Overview
Mandibular advancement devices may reduce blood pressure among patients with hypertension and obstructive sleep apnea. A study involving 220 patients demonstrated greater adherence and blood pressure reductions in the mandibular advancement device group compared to the CPAP group.
Background
Obstructive sleep apnea (OSA) is a prevalent condition that can exacerbate hypertension, complicating its management. Continuous positive airway pressure (CPAP) is the standard treatment; however, patient adherence is often low due to discomfort. Mandibular advancement devices work by repositioning the lower jaw and tongue to keep the airway open and may offer a more tolerable alternative for patients who struggle with CPAP.
Data Highlights
| Device Type | Adherence (%) | 24-hour Mean BP Reduction (mmHg) |
|---|---|---|
| Mandibular Advancement Device | 56.5 | 1.64 |
| CPAP Device | 23.2 | Reference |
Key Findings
- Mandibular advancement devices showed a 1.64 mmHg greater reduction in 24-hour ambulatory mean blood pressure compared to CPAP.
- Patients using mandibular advancement devices had higher adherence rates (56.5%) compared to those using CPAP (23.2%).
- Both groups experienced reductions in nighttime blood pressure, with the mandibular advancement device group achieving better results.
- 56.5% of patients with mandibular advancement devices achieved systolic blood pressure below 120 mmHg.
Clinical Implications
Clinicians should consider patient adherence when discussing treatment options for obstructive sleep apnea.
Conclusion
Further studies are needed to understand the benefits of mandibular advancement devices in managing blood pressure in patients with obstructive sleep apnea.
Related Resources & Content
- Chi-Hang et al., American College of Cardiology, 2024 -- Mandibular Advancement Device vs CPAP in Patients With Obstructive Sleep Apnea
- Ou et al., Journal of the American College of Cardiology, 2024 -- Effects of mandibular advancement devices vs. CPAP on blood pressure in obstructive sleep apnea: a systematic review and meta-analysis of randomized controlled trials
- compendium — Oral Appliance Therapy for Obstructive Sleep Apnea: From Treatment Alternative to First-Line Care
- ADA News — January JADA outlines emerging dental therapies for obstructive sleep apnea
- conexiant — A Smarter Screen for Sleep Apnea Stimulation
- 2025 AHA/ACC Hypertension Guideline
- Evaluation and management of obstructive sleep apnea in adults hospitalized for medical care
- CRESCENT: Mandibular Advancement Noninferior to CPAP For Sleep Apnea - American College of Cardiology
- Continuous Positive Airway Pressure Versus Mandibular Advancement Devices Impact on Cardio-Metabolic Outcomes in Patients With Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis of Randomised Controlled Trials - PubMed
- Effects of CPAP on Blood Pressure Parameter Across Different Severities of Obstructive Sleep Apnoea: A Meta‐Analysis
- Continuous Positive Airway Pressure vs Mandibular Advancement Device in Reducing Obstructive Sleep Apnea Symptoms: A Systematic Review and Meta-analysis | American Journal of Respiratory and Critical Care Medicine | Oxford Academic
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