Wearing a mouthguard could help treat high blood pressure caused by sleep apnea
Mandibular Advancement vs. CPAP for Blood Pressure Reduction in Patients with Obstructive Sleep Apnea - ScienceDirect
https://www.sciencedirect.com/science/article/pii/S0735109724009069
Sleep apnea: Mouthguards are less invasive, just as effective as CPAP
OSA is the most common type of sleep-related breathing disorder, with people ceasing breathing up to 30 times per hour. Continuous positive airway pressure (CPAP) is a commonly used treatment for OSA, which delivers pressurized air to the airways through a face mask or nasal mask.
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However, CPAP tends to cause discomfort to patients, and there are pros and cons to using it to treat OSA.
On the other hand, in recent years, a new treatment has been established called a mandibular advancement device (MAD), which is a mouthguard-like device that holds the lower jaw and tongue forward and keeps the airway open.
Previous studies have shown that MAD therapy is less invasive than CPAP and is more effective than CPAP in treating the number of complete cessation of breathing (apnea) or partial cessation of breathing (hypopnea) per hour during sleep.
In this study, a research team from the National University of Singapore and the University of Sydney conducted a comparative study on the effectiveness of MAD and CPAP in reducing hypertension in patients with moderate to severe OSA.
The study recruited 220 participants with moderate to severe OSA and randomly assigned to receive either MAD or CPAP treatment. Of the participants, 44.5% were overweight, 49.5% were obese, and 44.1% had high blood pressure for 10 years or more.
The research team followed up the subjects for six months, during which they were fitted with a device to constantly monitor their blood pressure, and were required to regularly complete questionnaires about sleepiness and undergo blood tests.
After six months of treatment, no significant difference was observed in the 24-hour mean blood pressure in subjects treated with CPAP, while MAD significantly reduced mean blood pressure by 1.64 mmHg when comparing the MAD and CPAP groups.
In addition, the MAD group showed a lower rise in nighttime blood pressure compared to the CPAP group, and more subjects recorded a maximum blood pressure of less than 120 mmHg. Based on these data, the research team concluded that MAD treatment was not inferior to CPAP.
The research team also looked at how long participants continued to use their assigned treatment. As a result, only 23.2% of participants assigned to CPAP were still wearing the device for an average of 6 hours or more per night after 6 months, while 56.5% of participants assigned to MAD were still wearing the device for an average of 6 hours or more per night after 6 months. 'The reason we saw a higher therapeutic effect in participants assigned to MAD is because they wore the device for longer than CPAP,' said Chi Han, a member of the research team.
'Approximately 400 million people worldwide suffer from moderate to severe OSA. However, many patients are underdiagnosed and need to be aware that this may contribute to high blood pressure. Patients, especially those who have difficulty controlling their blood pressure or who suffer from excessive daytime sleepiness, should see a doctor about OSA and seek treatment if necessary,' Han advises.
The researchers also noted that most of the participants in this study were East Asian men, so they plan to investigate whether MAD treatment can be applied to other races and genders, and to study the effects of MAD on cognition in the future.
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