cardiovascular effects of oral appliances in obstructive sleep apnea

Oral  appliances  (ОА)  are  one  of  the  leading  methods  of  effective  treatment  of  sleep-related  breathing disorders. Obstructive sleep apnea (OSA) is a widespread disturbance in the general population. It is closely associated with many cardiovascular diseases (hypertension, cardiac arrhythmias, chronic heart failure, ischemic heart disease). Timely detection and treatment of OSA is an important task in the process of reducing the number of cardiac complications. Modern devices for the treatment of OSA are custom-made devices which allow to change the position of the mandible and its extension providing personalized treatment of snoring and sleep apnea. Changing the degree of the mandible extension, the ОА retains the upper respiratory tract in open position and indirectly stimulates the muscles, determining their tone. The effectiveness of the ОА is evaluated by the complete elimination of all respiratory events (snoring, upper airway resistance syndrome, OSA and hypopnea), as well as the influence on the sleep structure and the wakefulness functioning (excessive daytime sleepiness). The effects of ОА on cardiovascular diseases are of great importance, as they showed a decrease in both systolic and diastolic blood pressure, as well as a positive effect on the impaired endothelial function. Among all the treatment options, ОА take the leading positions, only slightly inferior in effectiveness to noninvasive ventilation, so called CPAP therapy. Regarding the long-term adherence to therapy (which is especially important in the cardiovascular prevention) оral appliances exceed CPAP therapy. Thus, the OA therapy is one of the leading therapeutic directions in modern sleep medicine for obstructive sleep-related breathing disorders.