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

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Mandibular advancement devices (MAD) showed trends of blood pressure reduction compared to inactive controls in patients with obstructive sleep apnea (OSA).
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MAD achieved a significantly greater reduction in daytime systolic blood pressure compared to CPAP, with a mean difference of -1.99 mmHg.
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While CPAP was more effective in reducing the apnea-hypopnea index, MAD and CPAP had comparable effects on subjective sleepiness as measured by the Epworth Sleepiness Scale.
4

MAD demonstrated significantly longer nightly adherence than CPAP, with a mean difference of 0.71 hours per night.
5

MAD may serve as a viable alternative for cardiovascular risk management in OSA patients who cannot tolerate CPAP, despite its inferiority in reducing AHI.

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