TY - JOUR T1 - Impact of mandibular advancement therapy on endothelial function in severe obstructive sleep apnoea JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.sleepandbreathing-2017.P31 VL - 3 IS - suppl 1 SP - P31 AU - Frédéric Gagnadoux AU - Jean-Louis Pepin AU - Bruno Vielle AU - Vanessa Bironneau AU - Frédérique Chouet-Girard AU - Sandrine Launois AU - Nicole Meslier AU - Jean-Claude Meurice AU - Xuan-Lan Nguyen AU - Audrey Paris AU - Pascaline Priou AU - Renaud Tamisier AU - Wojciech Trzepizur AU - François Goupil AU - Bernard Fleury Y1 - 2017/04/01 UR - http://openres.ersjournals.com/content/3/suppl_1/P31.abstract N2 - This study aimed to determine whether treatment with mandibular advancement device, the main alternative to continuous positive airway pressure, improves endothelial function in patients with severe OSA.We randomized patients with severe OSA and no medical history of cardiovascular disease to receive 2 months of treatment with either effective mandibular advancement device or a sham device. The primary outcome, change in reactive hyperemia index, a validated measurement of endothelial function, was assessed on intention-to-treat bases. An embedded micro sensor objectively measured treatment compliance. 150 patients [86% males; mean (SD) age, 54 (10); median [IQR] apnea-hypopnoea index, 41 [35-53]; mean Epworth sleepiness scale, 9.3 (4.2)] were randomized to effective mandibular advancement device (n=75) or sham device (n=75). In the intention-to-treat analysis, effective mandibular advancement device therapy was not associated with an improvement in endothelial function when compared to sham device. Office and ambulatory blood pressure outcomes did not differ between the 2 groups. Effective mandibular advancement device therapy was associated with significant improvements in apnea-hypopnea index (p<0.001), micro-arousal index (p=0.008), symptoms of snoring, fatigue and sleepiness (p<0.001). Mean objective compliance was 6.6 (1.4) h/night with effective mandibular advancement device vs 5.6 (2.3) h/night with sham device (p=0.006).Conclusion In moderately sleepy patients with severe OSA, mandibular advancement therapy reduced OSA severity and related symptoms with no effect on endothelial function and blood pressure despite high treatment compliance. ER -