Mandibular Advancement Device Matches CPAP for BP Reduction in OSA Patients: Study

The key findings of the studu were:

• In the MAD group, the 24-hour mean arterial BP decreased by 2.5 mmHg (P = 0.003) at six months compared to baseline.

• In the CPAP group, no significant change was observed (P = 0.374).

• The between-group difference in 24-hour mean arterial BP was -1.6 mmHg (95% confidence interval: -3.51 to 0.24), indicating non-inferiority (P < 0.001).

• The MAD group showed a larger reduction in all secondary ambulatory BP parameters compared to the CPAP group, with the most pronounced effects observed in asleep BP parameters.

• Both treatments improved daytime sleepiness, with similar between-group differences (P = 0.384).

• There were no significant between-group differences in cardiovascular biomarkers.

The study concludes that MAD is non-inferior to CPAP for reducing 24-hour mean arterial BP in patients with hypertension and increased cardiovascular risk. Given its effectiveness, MAD may provide an alternative treatment option for patients who cannot tolerate CPAP.

Reference:

Ou, Y.-H., Colpani, J. T., Cheong, C. S., Loke, W., Thant, A. T., Shih, E. C., Lee, F., Chan, S.-P., Sia, C.-H., Koo, C.-Y., Wong, S., Chua, A., Khoo, C.-M., Kong, W., Chin, C. W., Kojodjojo, P., Wong, P. E., Chan, M. Y., Richards, A. M., … Lee, C.-H. (2024). Mandibular advancement vs CPAP for blood pressure reduction in patients with obstructive sleep apnea. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2024.03.359