CPAP alternative comparable for reducing blood pressure (Mandibular advancement devices (MAD))

Medical Xpress / Am College of Cardiology / Journal of the American College of Cardiology ^ | April 8, 2024 | Yi-Hui Ou et al

[ConservativeMind]

People with hypertension and obstructive sleep apnea were no less likely to see their blood pressure drop over six months if they used a mandibular advancement device (MAD), which is inserted onto the teeth similar to a bite guard, compared to a continuous positive airway pressure (CPAP) device, according to research.

Obstructive sleep apnea can cause or worsen hypertension. Medical guidelines recommend the use of a CPAP machine to help keep airways open by delivering pressurized air through the mouth and nose.

MADs help keep the airway open by repositioning the lower jaw.

321 people with uncontrolled hypertension and high cardiovascular risk underwent a sleep study to determine whether they had obstructive sleep apnea. 220 were found to have moderate to severe obstructive sleep apnea and were randomly assigned to receive a MAD or CPAP device.

Participants were instructed to use their assigned device for six months while sleeping to the degree that they could tolerate it. Both devices had built-in trackers that recorded use.

At six months, people assigned to the MAD group experienced a drop in 24-hour ambulatory mean blood pressure that was 1.64 mmHg larger, on average, than those assigned to CPAP, meeting the threshold for non-inferiority and the trial's primary endpoint.

Compared with the CPAP group, the MAD group also showed a larger between-group reduction in all ambulatory blood pressure measures, especially nighttime blood pressure when the devices were being used, and an increased proportion of patients achieving a systolic blood pressure below 120 mmHg by the end of the study.

The adherence data revealed that over half (56.5%) of those who were assigned to use the MAD used the device for six or more hours per night on average over the study period, while under one-quarter (23.2%) of those assigned to CPAP did so.

[Mean Daddy]

Got my CPAP years ago & left it at home when my son had an out of town baseball tournament. Driving home, I almost fell asleep a dozen times. Now I won’t go overnight without it.

Couple months ago, threw a headpiece away on trash day only to find out I didn’t have a spare. Called my CPAP supply company next day and they said it would be a week before it got delivered so I drove across the river to Omaha that day and picked it up.

[Seaplaner]

I honestly thought that I could never adjust to my cpap.
I decided to give it a try,stayed optimistic,and maintained my sense of humor.
After a week I was okay, after a month it was my sweet dream machine.
I know personally several other success stories of adapting to cpap.
Sleep apnea is wayyyy under diagnosed and is responsible for a whole lotta seemingly unrelated health problems.
Cpap is worth a try

[Chicory]

The CPAP takes a bit of time to get used to. At first I had all these weird problems with it and my sleep was even more erratic than usual. But I kept going with it and it all came together slowly.

It helped a lot that my insurance would cover it only if I used it quite a bit and I was paranoid about what would happen if I didn’t adhere!