Oral appliances for obstructive sleep apnea lower blood pressure

Oral appliances are a type of mouth guard worn at night when asleep to treat obstructive sleep apnea (OSA). I use them in patients with mild to moderate OSA, and in those with severe OSA but who don't respond to CPAP. OSA is strongly associated with high blood pressure (HTN), and CPAP has been shown to help reduce HTN by treating OSA. There have not been many studies showing that oral appliances reduce blood pressure when used to treat OSA. This paper pooled data from 7 studies that measured blood pressure changes in OSA patients using an oral appliance. The results showed that in those with mild to moderate OSA, an oral appliance modestly improved blood pressure, and results were comparable to CPAP.