Approaches for Lowering Blood Pressure in Patients with Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is associated with nighttime oxygen desaturation, elevated blood pressure (BP), and excess risk for cardiovascular disease. The BP-lowering effect of two major treatments for OSA — continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs) — was assessed in this meta-analysis of 51 randomized trials (4888 patients) in which CPAP or MADs were compared mostly with inactive controls.

During mean follow-up of 4 to 15 weeks, CPAP was associated with mean reductions in systolic and diastolic BPs of 2.5 mm Hg and 2.1 mm Hg, respectively; corresponding reductions in systolic and diastolic BPs with MADs were 2.0 mm Hg and 1.9 mm Hg. The magnitude of BP lowering with CPAP correlated with duration…