Evaluating the effectiveness of continuous positive airflow pressure and mandibular advancement in the treatment of obstructive sleep apnea and coexisting hypertension
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Abstract
Throughout the past several decades, there has been an increased awareness about the prevalence obstructive sleep apnea (OSA) and the potential for OSA patients to develop even more serious medical consequences, particularly hypertension. For this reason, there has been considerable interest directed towards reducing OSA and OSA related symptoms. The two most commonly used non-surgical methods used to treat OSA are continuous positive airway pressure, or CPAP, and the use of mandibular advancement devices. Although CPAP is currently the gold-standard in OSA treatment, the device has been known to be costly and intolerable for many patients. This has led to a more recent shift in attention towards the use of mandibular advancement therapy. The aim ofthis study is to examine existing literature relevant to CPAP and mandibular advancement in order to determine their efficacy in the treatment of OSA and whether there is enough evidence to advocate the use of mandibular advancement devices as a first-line treatment of OSA. Previous studies linking OSA to hypertension were also examined to determine whether treatment of OSA using the aforementioned methods can result in a secondhand reduction in blood pressure for hypertensive OSA patients. This review has shown that both CPAP and mandibular advancement were very effective in treating OSA-related symptoms and reducing hypertension, as well. Although CPAP was more effective in patients with severe OSA, mandibular advancement yielded improvements similar to CPAP in mild and moderate cases of OSA. These results led to the conclusion that while CP AP is rightfully a prominent method of treating OSA, mandibular advancement devices are also very effective and are comfortable enough for patients to adhere to treatment for long periods of time.
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Thesis (M.A.)--Boston University
PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.
PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.