Evaluation of arterial stiffness and quality of life in the treatment of moderate to severe obstructive sleep apnea with Continuous Positive Airway Pressure or Mandibular Advancement Appliance: a cross-sectional study

BMC Cardiovasc Disord. 2024 Nov 20;24(1):657. doi: 10.1186/s12872-024-04344-6.

Abstract

Background: Obstructive sleep apnea (OSA) is highly associated with a significant reduction in the Quality of Life (QoL) and is associated with deleterious effects on the cardiovascular system. Arterial stiffness is characterized by morphofunctional changes in the arteries and its assessment can be obtained non-invasively mainly through the measurement of pulse wave velocity (PWV). Arterial stiffness has been proposed as a predictor of cardiovascular diseases.

Objective: To compare arterial stiffness as well as QoL in patients diagnosed with moderate to severe OSA treated with Continuous Positive Airway Pressure (CPAP) or Mandibular Advancement Appliance (MAA) therapies.

Methods: This is a cross-sectional study involving 105 participants diagnosed with moderate to severe OSA categorized into three independent groups: A Non-treated Control Group and CPAP and MAA treated Groups. QoL was assessed by the Quebec Sleep Questionnaire (QSQ) and arterial stiffness was assessed noninvasively by Mobil-O-Graph.

Results: The groups were homogeneous, except for the polysomnographic parameters Apnea and Hypopnea Index (AHI) (p = 0.036) and Minimum O2 saturation (p = 0.011) (evaluated to diagnose the OSA condition before treatment) and Body Mass Index (BMI) (p < 0.001). The MAA group presented higher scores in all QoL domains (p < 0.05), except Social Interactions in relation to the Control group. For the CPAP group, only Nocturnal Symptoms presented significantly higher scores compared to the control group (p = 0.39). For Arterial Stiffness, no statistical differences were observed among comparisons.

Conclusions: Our results show better QoL scores in patients with OSA treated by CPAP and mainly by MAA. Differently, arterial stiffness parameters did not differ between the groups treated with CPAP and MAA and the control group.

Keywords: Apnea; Arterial stiffness; Hypopnea; Hypoxemia; Upper airway.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Continuous Positive Airway Pressure*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Mandibular Advancement* / instrumentation
  • Middle Aged
  • Polysomnography
  • Pulse Wave Analysis
  • Quality of Life*
  • Severity of Illness Index*
  • Sleep Apnea, Obstructive* / diagnosis
  • Sleep Apnea, Obstructive* / physiopathology
  • Sleep Apnea, Obstructive* / therapy
  • Surveys and Questionnaires
  • Treatment Outcome
  • Vascular Stiffness*