To Help Your Heart, Treat Your Sleep

Continuous positive airway pressure, mandibular advancement devices linked to lower blood pressure in obstructive sleep apnea patients

/ Author:  / Reviewed by: Jennifer Gershman, PharmD, CPh

(RxWiki News) Obstructive sleep apnea (OSA) and high blood pressure can be a dangerous combination. But new evidence suggests that treating one condition may have the added benefit of treating the other.

A new study from Switzerland found that the OSA treatments continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs) were both linked to reductions in systolic and diastolic blood pressure.

Sleep apnea is a disorder in which breathing repeatedly stops and starts during sleep. The most common form of sleep apnea is OSA, which occurs when the throat muscles repeatedly relax and block the airway during sleep. The most noticeable sign of this condition is snoring.

Sudden drops in blood oxygen levels that occur during OSA can increase blood pressure and put strain on patients' cardiovascular systems, according to the Mayo Clinic. As a result, many OSA patients develop chronic high blood pressure, which can increase the risk of heart disease and stroke.

CPAP is a common OSA treatment that uses a machine to deliver air pressure through a piece that fits into the nose or over the nose and mouth while a patient sleeps. This air pressure keeps the upper airway passages open to prevent OSA.

MADs, which open the airway by moving the mandible (lower jaw) forward, are another common OSA treatment.

For this study, a team of researchers led by Malcolm Kohler, MD, head the Department of Pulmonology at University Hospital Zurich in Switzerland, looked at the potential link between these treatments and blood pressure.

Systolic blood pressure (SBP) measures the pressure in the arteries when the heart beats. Diastolic blood pressure (DBP) measures the pressure in the arteries between heartbeats.

These researchers compiled data from 51 past studies with a total of 4,888 patients. Of these studies, 44 compared CPAP to placebo, three compared MADs to placebo, one compared CPAP to MADs, and three compared all three.

Compared to placebo, Dr. Kohler and team found that CPAP was tied to a 2.5 mm Hg drop in SBP and a 2 mm Hg drop in DBP. MADs were tied to a 2.1 mm Hg drop in SBP and 1.9 mm Hg drop in DBP.

No significant differences between the blood pressure outcomes with these treatments were found.

This study was published Dec. 1 in the journal JAMA.

The Swiss National Science Foundation and the University of Zurich Clinical Research Priority Program Sleep and Health funded this research. No conflicts of interest were disclosed.

Review Date: 
November 30, 2015
Last Updated:
December 1, 2015