CASE REPORT article
Front. Sleep
Sec. Sleep and Breathing
Volume 4 - 2025 | doi: 10.3389/frsle.2025.1580381
This article is part of the Research TopicNovel approaches for treating obstructive sleep apneaView all articles
Case Report: Combination Oral Appliance Therapy Acute Influence on Cardiac Electrophysiology and Hemodynamics in OSA Patient with Paroxysmal Atrial Fibrillation
Provisionally accepted
- Department of Health Sciences, Texas A&M University Baylor College of Dentistry, Dallas, United States
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1. ABSTRACT Background/Objectives Sleep apnea-related autonomic responses may increase cardiac arrhythmias. Ablation, cardioversion, and pharmacologic therapies for paroxysmal atrial fibrillation (AF) could benefit from adjunctive oral appliance therapy with a mouth shield (OAT+) compared to auto-adjusting positive airway pressure (APAP). Methods: A 67-year-old male with moderate obstructive sleep apnea (OSA), AF history, three ablations, and on Carvedilol (10 mg daily) underwent home sleep recordings with APAP and with OAT+ after four weeks. Randomly selected premature atrial contractions (PACs; n=20) and time-linked plethysmography waves from each intervention were compared. Results: OAT+ reduced the PAC index (-61.9%), cardiac conduction intervals (nR-R, p=.025; pre-PAC R-R, p=.003; R-PAC-R, p=.051; PAC R-post systolic pause-R, p<.001) except for a P-R interval increase (p=.032). PAC-associated plethysmography wave amplitudes increased with OAT+ (pre-PAC wave-1, p<.001; PAC wave-2, p=.023; post-PAC wave-3, p<.001). Conclusions: OAT+ shows promise as an adjunct AF therapy in OSA patients, improving cardiac conduction and vascular function over APAP.
Keywords: Oral appliance, obstructive sleep apnea, Premature atrial contraction, Plethysmography, auto-adjusting positive airway pressure
Received: 20 Feb 2025; Accepted: 10 Oct 2025.
Copyright: © 2025 Schramm, Schneiderman, Hui, German and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Preetam Schramm, preetamschramm@gmail.com
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