Effects of mandibular advancement devices vs. CPAP on blood pressure in obstructive sleep apnea: a systematic review and meta-analysis of randomized controlled trials - Report - MDSpire

Effects of mandibular advancement devices vs. CPAP on blood pressure in obstructive sleep apnea: a systematic review and meta-analysis of randomized controlled trials

  • By

  • Ting Cheng

  • Qiang Wang

  • Wei Wei

  • May 20, 2026

  • 0 min

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Clinical Report: Comparative Analysis of Blood Pressure Outcomes in OSA

Overview

This systematic review and meta-analysis evaluates the effects of mandibular advancement devices (MAD) versus continuous positive airway pressure (CPAP) on blood pressure in patients with obstructive sleep apnea (OSA). Findings indicate that MAD provides comparable cardiovascular benefits to CPAP, with a significant reduction in daytime systolic blood pressure and superior adherence rates.

Background

Obstructive sleep apnea (OSA) is a prevalent condition associated with hypertension and increased cardiovascular risk. CPAP is the standard treatment; however, adherence issues limit its effectiveness. MADs have emerged as a viable alternative, particularly for patients who cannot tolerate CPAP, warranting a comparative analysis of their effects on blood pressure outcomes.

Data Highlights

{'AHI Reduction': 'MD = -8.45 events/h (CPAP), p < 0.001'}

Key Findings

{'AHI Reduction': 'CPAP was more effective in reducing the apnea-hypopnea index (MD = -8.45 events/h, p < 0.001).'}

Clinical Implications

For patients with OSA who struggle with CPAP adherence, MAD may be a suitable alternative that provides similar cardiovascular benefits. Clinicians should consider patient preferences and adherence potential when recommending treatment options for OSA.

Conclusion

MAD offers cardiovascular benefits comparable to CPAP while achieving better adherence rates, making it a viable option for managing blood pressure in OSA patients who cannot tolerate CPAP.

Related Resources & Content

  1. Author(s)/Org, Source, Year -- Title
  2. Author(s)/Org, Source, Year -- Outcomes Before and After Bariatric Surgery in Patients with Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis
  3. Author(s)/Org, Source, Year -- Use of Automatic Positive Airway Pressure in Managing Obstructive Sleep Apnea Among Patients with Heart Failure and Reduced Ejection Fraction
  4. Author(s)/Org, Source, Year -- Machine Learning–Based Multidimensional Oximetry for Obstructive Sleep Apnea Screening: Development and External Validation
  5. Current guideline position and clinical consensus, 2025 -- VA/DoD OSA guideline
  6. Long-term effect of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea | Journal of Human Hypertension
  7. CPAP Alternative Comparable for Reducing Blood Pressure - American College of Cardiology
  8. https://www.healthquality.va.gov/guidelines/CD/insomnia/I-OSA-CPG_2025-Guideline_final_20250915.pdf
  9. Long-term effect of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea | Journal of Human Hypertension
  10. CPAP Alternative Comparable for Reducing Blood Pressure - American College of Cardiology

Original Source(s)

Effects of mandibular advancement devices vs. CPAP on blood pressure in obstructive sleep apnea: a systematic review and meta-analysis of randomized controlled trials

  • by Ting Cheng, Qiang Wang, Wei Wei

  • May 20, 2026

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