[Effects of oral appliance treatment upon blood pressure in mild to moderate obstructive sleep apnea-hypopnea syndrome].
OBJECTIVE
To evaluate the effects of oral appliance (OA) treatment upon systemic blood pressure (BP) in mild to moderate patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).


METHODS
Forty-six consecutive patients diagnosed with OSAHS on polysomnography were divided into OA treatment group (OA group, 25 patients, 15 patients with hypertension) and non-tolerated OA treatment group (N-OA group, 21 patients, 13 patients with hypertension). Polysomnography and 24-hour ambulatory blood pressure monitoring (ABPM) were performed at baseline in two groups. Polysomnography and ABPM were repeated after a completion of 12 weeks of treatment in OA group and after a cessation of treatment for 12 weeks in N-OA group. Hypertensive patients in two groups continued taking the same kind and the same dose of antihypertensive agents during the period of study.


RESULTS
There was no significant difference between the two groups in age, body mass index, Epworth sleepiness score (ESS), apnoea-hypopnoea index (AHI), arousal index (AI) and minimum arterial oxygen saturation (MSaO2) at baseline. After a 12-week treatment, OA group showed significant improvement in AHI [(7.0 +/- 3.8) vs (21.0 +/- 6.5) per hour, P < 0.01], AI [(22.9 +/- 6.3) vs (32.2 +/- 9.3) per hour, P < 0.01] and MSaO2 (86.8% +/- 3.5% vs 80.0% +/- 5.2%, P < 0.01), while nocturnal mean systolic blood pressure (SBP) and diastolic blood pressure (DBP), 24-hour and diurnal SBP, and nocturnal mean artery pressure (MAP) were significantly reduced [(121.3 +/- 7.0) vs (125.3 +/- 9.3), (76.1 +/- 6.1) vs (78.8 +/- 6.8), (127.2 +/- 7.5) vs (129.4 +/- 8.8), (131.5 +/- 6.9) vs (133.6 +/- 8.1), and (91.2 +/- 6.4) vs (94.3 +/- 7.6) mm Hg respectively, all P < 0.01]. The reduction in nocturnal MAP was significantly correlated to improvement in AI(r = 0.37, P = 0.005) and AHI (r = 0.32, P = 0.011), to baseline nocturnal mean blood pressure (SBP: r = 0.39, P = 0.015; DBP: r = 0.30, P = 0.024). The N-OA group showed no differences in blood pressure variables between baseline and after a cessation of treatment for 12 weeks.


CONCLUSIONS
Oral appliance treatment for mild to moderate OSAHS may lead to a reduction in systemic blood pressure.
Zhang
Li-Qiang
LQ
Department of Respiratory Medicine, Peking University Third Hospital, Beijing 100191, China. byzlq@163.com
Zheng
Xu
X
Wang
Jian-Li
JL
Wang
Yu-Zhu
YZ
Ren
Bin
B
He
Bei
B
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010845:Obesity Hypoventilation Syndrome / Q000628:therapy; D009967:Orthodontic Appliances; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D016896:Treatment Outcome