Using a CPAP or Mandibular Advancement Device

Using a CPAP or Mandibular Advancement Device

Airway and sleep disorders affect millions of Americans of all ages, even children. The AAPMD is in search of a collaborative effort between practitioners that treat airway and sleep disorders, which could lead to more effective treatments that are individualized for each patient.

Patients with obstructive sleep apnea (OSA) tend also to experience high blood pressure and bear a greater risk of cardiovascular disease. For patients suffering from OSA, a continuous positive airway pressure machine (CPAP) or use ofCPAP or Mandibular Advancement Device mandibular advancement devices (MADs) have proven to be effective treatment for their sleep disorder symptoms but researchers want to know more. Could these treatment options also positively affect their blood pressure, for patients with OSA?

A recent systemic review and meta-analysis conducted clinical trials that were randomized, by comparing the effects that CPAP and MADs had on the blood pressure of patients suffering from OSA. The trail considered results from the CPAP and MADs, versus each other, and versus an inactive control. In all, 872 studies were identified initially but there were 51 studies selected for analysis. These 51 studies consisted of 4,888 patients. Separate individuals conducted the data extraction and synthesis. The analytic technique used was meta-regression, which determined the association between the trial characteristics and the effects of CPAP versus the inactive control that was reported.

The conclusion of this study determined that both the CPAP and MADs helped reduce the blood pressure in individuals suffering from OSA. There were no statistically significant differences between which treatment produced greater results, according to the network meta-analysis that was used. By understanding this association between treatment for OSA and the reduction of blood pressure, physicians can better treat patients with a customized treatment plan.

Bratton DJ, Gaisl T, Wons AM, Kohler M. CPAP vs Mandibular Advancement Devices and Blood Pressure in Patients With Obstructive Sleep Apnea: A Systematic Review and Meta-analysis. JAMA. 2015;314(21):2280-2293. doi:10.1001/jama.2015.16303.

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