High blood pressure (hypertension) is one of the most common effects of sleep apnea (indeed, several screening tools for sleep apnea use it as a clinical indicator). It also has many ramifications in the systemic effects of sleep apnea, such as heart problems, kidney problems, glaucoma, and other potential consequences.
Lowering blood pressure is one of the key goals of sleep apnea treatment, so now that we have a new review showing that oral appliances do the job just as well as CPAP, it becomes clear that these two therapies are both good approaches to treating sleep apnea.
A Large Meta-Review
This new data comes not just from a single study, but from a systematic review and analysis of dozens of published studies on these treatment techniques and their impact on high blood pressure. It is published in the Journal of the American Medical Association (JAMA), one of the most prestigious medical journals in the world. It therefore represents some of the strongest evidence yet of the relative value of oral appliance therapy (or mandibular advancement devices (MADs) as the article refers to them) and CPAP.
The review of 51 studies (covering nearly 5000 patients) looked at 44 studies that compared CPAP with an inactive control, one that compared CPAP and oral appliances, three that compared oral appliances and inactive control, and three that compared CPAP, oral appliances, and control. It compiled the relative reductions in systolic blood pressure (SBP) and diastolic blood pressure (DBP). For CPAP, this was 2.5 and 2.0 mm Hg, respectively, while oral appliances led to reductions of 2.1 and 1.9 mm Hg, respectively.
Although the reductions were slightly higher for CPAP, analysis showed that the two were statistically equivalent.
Which Treatment Works for You?
With these two treatments proven to be essentially comparable in this respect, greater emphasis has to be placed, again, on which treatment a patient will actually use. If you don’t use your sleep apnea treatment, you get essentially no benefit, so it’s the same as having no treatment.
For many people, CPAP just proves to be too cumbersome and inconvenient to use regularly. Or maybe they don’t use it long enough each night. For many of these people, oral appliance therapy proves to be convenient and comfortable, resulting in much higher compliance rates and better treatment outcomes. If you are struggling with your CPAP for sleep apnea, you need to know that there is another option that works as well. To learn whether oral appliances will work for your sleep apnea, please call (619) 299-5925 for an appointment with a San Diego sleep dentist at Strober Dental.