Evaluating efficacy of mandibular advancement device in patients with essential hypertension and obstructive sleep apnea

Study Objectives: Obstructive sleep apnea (OSA) has a close association with hypertension and often leads to uncontrolled hypertension. One treatment modality for mild to moderate OSA is the mandibular advancement device (MAD). The goal of the current study was to evaluate the effect of the MAD on blood pressure and sleep apnea severity. Methods: A total of 25 participants, screened for OSA using the STOP-Bang Questionnaire, and underwent a level 3 home sleep test. Based on apnea-hypopnea index (AHI) calculated from a level 3 home sleep test, selected participants with mild to moderate OSA underwent 24-hour ambulatory blood pressure monitoring. The monoblock type of custom-made MAD was fabricated for each of 21 selected participants. After 1 month of MAD therapy, a level 3 home sleep apnea test was performed again with the MAD in position and 24-hour ambulatory blood pressure monitoring were repeated for comparison with both parameters before MAD therapy. Results: MAD therapy resulted in significant reduction of systolic and diastolic blood pressure (p<0.05) and simultaneous reduction in AHI was also reported (P<0.05). Conclusions: MAD therapy is associated with significant reduction in AHI and ambulatory blood pressure in subjects with essential hypertension and OSA.