title: Effect of oral appliance therapy on blood pressure in Japanese patients with obstructive sleep apnea.
abstract: OBJECTIVE
  Obstructive sleep apnea (OSA) treatment in patients with OSA and hypertension reduces blood pressure (BP). Oral appliance (OA) therapy is nowadays prescribed for patients with mild to moderate OSA. This study aimed to clarify the effect of OA therapy on BP reduction in Japanese patients with mild to moderate OSA.
  
  
  METHODS
  Polysomnography was employed to detect sleep-disordered breathing. Totally, 237 patients without cardiac and/or cerebrovascular diseases and those with apnea-hypopnea index (AHI) ≥ 5/h-< 30/h were enrolled. Office BP change after receiving 8-12 weeks of OA therapy was assessed and the factors related to the degree of BP reduction were analyzed.
  
  
  RESULTS
  The study patients consisted of 188 men and 49 women, the mean age was 54.7 ± 13.2 years old, and the body mass index (BMI) was 24.6 ± 3.4 kg/m(2). The antihypertensive effect of OA therapy resulted in systolic BP (SBP) -2.4 ± 14.8 (p = 0.078) and diastolic BP (DBP) -2.0 ± 11.7 mm Hg (p = 0.045) in all patients. SBP before OA therapy played a significant role in the degree of SBP reduction (β = -0.597, p < 0.001), whereas DBP before OA therapy was a significant factor of the degree of DBP reduction (β = -0.522, p < 0.001).
  
  
  CONCLUSIONS
  A certain time period of OA therapy effected BP reduction in mild to moderate OSA patients without cardiac and/or cerebrovascular diseases. Its antihypertensive effect was greater in OSA patients whose BP was higher before receiving OA therapy.
authors.affiliation: a Division of Cardiology, Department of Internal Medicine , St. Marianna University School of Medicine , Kawasaki , Kanagawa , Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Sekizuka
authors.affiliation: a Division of Cardiology, Department of Internal Medicine , St. Marianna University School of Medicine , Kawasaki , Kanagawa , Japan.
authors.forename: Naohiko
authors.initials: N
authors.lastname: Osada
authors.affiliation: a Division of Cardiology, Department of Internal Medicine , St. Marianna University School of Medicine , Kawasaki , Kanagawa , Japan.
authors.forename: Yoshihiro J
authors.initials: YJ
authors.lastname: Akashi
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D001795:Blood Pressure Determination / Q000379:methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D007564:Japan; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods; D012138:Respiratory Therapy / Q000295:instrumentation / Q000379:methods; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome
keywords: Hypertension; mandibular advancement device; office blood pressure; polysomnography; sleep-disordered breathing