From the Guidelines
Alternative non-invasive treatments for obstructive sleep apnea (OSA), such as mandibular advancement devices (MADs), can help address heart disease risks by reducing sleep apneas and improving quality of life, as evidenced by studies showing beneficial cardiovascular effects from MADs 1. The primary goal of these treatments is to prevent the repeated oxygen drops and sleep disruptions of OSA that contribute to hypertension, arrhythmias, heart failure, and coronary artery disease. Some key points to consider when using alternative non-invasive treatments for OSA to address heart disease include:
- MADs are recommended for the treatment of patients with mild to moderate OSA and in patients who do not tolerate CPAP, as they reduce sleep apneas and subjective daytime sleepiness and improve quality of life compared with control treatments 1.
- CPAP more effectively reduces sleep apneas, but MADs have emerging evidence on beneficial cardiovascular effects, making them a viable alternative for patients who cannot tolerate CPAP 1.
- Other alternatives, such as positional therapy and lifestyle modifications, can also be effective in managing OSA and reducing heart disease risks.
- Patients with existing heart disease should work with both sleep and cardiology specialists to coordinate their treatment approach, as effectively managing OSA can reduce inflammation, normalize blood pressure, improve heart rhythm, and decrease the workload on the heart, potentially slowing or preventing the progression of heart disease in OSA patients.
From the Research
Alternative Non-Invasive Treatments for OSA and Heart Disease
- Alternative non-invasive treatments for Obstructive Sleep Apnea (OSA) have been explored to address the associated risk of heart disease.
- Studies have shown that oral appliance therapy, specifically mandibular advancement devices (MAD), can be an effective treatment option for OSA, reducing the severity of the condition and improving health outcomes 2, 3.
- However, the relationship between alternative non-invasive treatments for OSA and heart disease is not fully understood, with some studies suggesting that treatment of OSA can reduce the incidence of cardiac comorbidities and improve cardiovascular health 4, 5.
- The use of MAD therapy has been shown to significantly reduce the mean apnea-hypopnea index (AHI) and improve minimum oxygen saturation, indicating a potential benefit for cardiovascular health 3.
- Additionally, treatment of OSA with alternative non-invasive methods, such as oral appliances, may be beneficial for patients who are unable to tolerate traditional continuous positive airway pressure (CPAP) therapy 6.
Mechanisms and Outcomes
- The mechanisms by which alternative non-invasive treatments for OSA address heart disease are not fully understood, but may involve reduction of nocturnal hypoxia-normoxia cycling and attenuation of the apnea-hypopnea index 6.
- Studies have reported varying degrees of success with alternative non-invasive treatments for OSA, with some showing significant reductions in AHI and improvements in cardiovascular health 3, 5.
- Further research is needed to fully understand the relationship between alternative non-invasive treatments for OSA and heart disease, and to determine the most effective treatment options for patients with OSA and cardiovascular comorbidities 6, 5.