Treatment methods for obstructive sleep apnea （OSA） in Japan include nasal continuous positive airway pressure （nCPAP） therapy and oral appliance （OA） therapy, and OA is primarily used for mild OSA. Although the treatment of OSA associated with cardiovascular disease has been discussed, the significance of treating OSA associated with mild OSA is not clear, and the effect of OA therapy is not apparent in many cases. In addition, treatment of OSA associated with cardiovascular disease is often applied to patients without symptoms, and adherence to nCPAP is often poor. This paper reviews studies on the effects of OSA on concomitant cardiovascular disease and the consequences of nCPAP and OA therapy. As a cardiologist, I would like to express my opinion on OA therapy for OSA, including therapy for milder OSA cases.
Although OA therapy is widely used internationally and not only for mild OSA, the significance of treatment for mild OSA remains largely unclear. In future, OA therapy may have great potential for treating OSA complicated by cardiovascular diseases. By clarifying the significance of treatment for mild OSA and asymptomatic OSA, the number of situations in which OA therapy is used will increase. I sincerely hope that dentists will become more interested in treating OSA patients by asking about sleepiness symptoms and functional problems during the day and monitoring lifestyle-related disease management, including blood pressure.
