Upper airway surgery: the effect on nasal continuous positive airway pressure titration on obstructive sleep apnea patients

2006 ◽  
Vol 263 (5) ◽  
pp. 481-486 ◽  
Author(s):  
Adriane Iurck Zonato ◽  
Lia Rita A. Bittencourt ◽  
Fernanda Louise Martinho ◽  
Luiz Carlos Gregório ◽  
Sergio Tufik
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Upper Airway ◽  
Upper Airway Surgery ◽  
Airway Surgery ◽  
Obstructive Sleep

The effect of multilevel upper airway surgery on continuous positive airway pressure therapy in obstructive sleep apnea/hypopnea syndrome

2009 ◽  
Vol 119 (1) ◽  
pp. 193-196 ◽  
Author(s):  
Michael Friedman ◽  
Rohit Soans ◽  
Ninos Joseph ◽  
Samir Kakodkar ◽  
Jacob Friedman
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Upper Airway ◽  
Pressure Therapy ◽  
Upper Airway Surgery ◽  
Obstructive Sleep ◽  
Hypopnea Syndrome

Upper airway surgery benefits patients with obstructive sleep apnoea who cannot tolerate nasal continuous positive airway pressure

2004 ◽  
Vol 118 (4) ◽  
pp. 270-274 ◽  
Author(s):  
Melanie A. Souter ◽  
Scott Stevenson ◽  
Bryn Sparks ◽  
Chris Drennan
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Obstructive Sleep Apnoea ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Upper Airway Surgery ◽  
Nasal Cpap ◽  
Airway Surgery ◽  
Obstructive Sleep

Nasal continuous positive airway pressure (CPAP) is the mainstay of treatment for patients with moderate to severe obstructive sleep apnoea (OSA). However, tolerance and compliance are poor.An audit using the Christchurch Hospital ORL surgery database identified patients who underwent upper airway surgery for OSA. Tracheostomy and bimaxillary advancement patients were excluded. Adults with moderate to severe OSA (Desaturation Index (DI) >10 n.h-1), who had failed atrial of nasal CPAP, and had pre-operative and post-operative sleep study data were identified. Objective (DI) and Subjective (Epworth Sleepiness Score (ESS)) outcome measures were recorded.The database identified 69 patients who underwent surgery for snoring or OSA; of these, 25 patients formed the study group. Sixteen out of 25 improved (64 per cent) after surgery, seven out of 25 showed no change (28 per cent), two patients (eight per cent) showed deterioration in their DI. Forty-eight per cent of patients had >50 per cent post-operative improvement in DI. Fourteen out of 25 (56 per cent) had a post-operative DI <20 n.h-1. Seven out of 25 (28 per cent) had a post-operative DI <10 n.h-1. Upper airway surgery has a role in the managementof selected patients with OSA who cannot tolerate nasal CPAP.

scholarly journals Nasendoscopic Observation of Upper Airway during Treatment of Obstructive Sleep Apnea with Nasal Bilevel Continuous Positive Airway Pressure.

1994 ◽  
Vol 87 (5) ◽  
pp. 679-687
Author(s):  
Tatsuya SADAOKA ◽  
Noriya KAKITSUBA ◽  
Yuki FUJIWARA ◽  
Ibuki HAYASHI ◽  
Hiroaki TAKAHASHI ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Upper Airway ◽  
Obstructive Sleep

scholarly journals Continuous positive airway pressure treatment does not normalize the prolonged reflex inhibition to inspiratory loading in obstructive sleep apnea

2016 ◽  
Vol 121 (4) ◽  
pp. 910-916
Author(s):  
Nicholas P. S. Murray ◽  
David K. McKenzie ◽  
Simon C. Gandevia ◽  
Jane E. Butler
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Obstruction ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Upper Airway ◽  
Cpap Therapy ◽  
Airway Occlusion ◽  
Obstructive Sleep

In obstructive sleep apnea (OSA), the short-latency inhibitory reflex (IR) of inspiratory muscles to airway occlusion is prolonged in proportion to the severity of the OSA. The mechanism underlying the prolongation may relate to chronic inspiratory muscle loading due to upper airway obstruction or sensory changes due to chronic OSA-mediated inflammation. Continuous positive airway pressure (CPAP) therapy prevents upper airway obstruction and reverses inflammation. We therefore tested whether CPAP therapy normalized the IR abnormality in OSA. The IR responses of scalene muscles to brief airway occlusion were measured in 37 adult participants with untreated, mostly severe, OSA, of whom 13 were restudied after the initiation of CPAP therapy (usage >4 h/night). Participants received CPAP treatment as standard clinical care, and the mean CPAP usage between initial and subsequent studies was 6.5 h/night (range 4.1-8.8 h/night) for a mean of 19 mo (range 4–41 mo). The duration of the IR in scalene muscles in response to brief (250 ms) inspiratory loading was confirmed to be prolonged in the participants with OSA. The IR was assessed before and after CPAP therapy. CPAP treatment did not normalize the prolonged duration of the IR to airway occlusion (60 ± 21 ms pretreatment vs. 59 ± 18 ms posttreatment, means ± SD) observed in participants with severe OSA. This suggests that the prolongation of IR reflects alterations in the reflex pathway that may be irreversible, or a specific disease trait.

scholarly journals Perioperative Management of Obstructive Sleep Apnea With Nasal Continuous Positive Airway Pressure

2008 ◽  
Vol 55 (4) ◽  
pp. 121-123 ◽  
Author(s):  
Hirofumi Arisaka ◽  
Shigeki Sakuraba ◽  
Reiko Kobayashi ◽  
Homare Kitahama ◽  
Naofumi Nishida ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Perioperative Period ◽  
Obstructive Sleep ◽  
Analgesic Agents

Abstract The high risks associated with general anesthesia in obstructive sleep apnea syndrome (OSAS) patients have been reported. Many authors have suggested that the intraoperative administration of opioids and sedatives should be limited or avoided because these drugs selectively impair muscle activity in the upper airway. We report the case of an OSAS patient who was managed with nasal continuous positive airway pressure (NCPAP) and treated safely in spite of the use of conventional anesthetic and analgesic agents typically used for patients without OSAS. She had little pain during the perioperative period. It is suggested that NCPAP is an effective treatment for not only preventing airway obstructive apnea but for allowing the administration of anesthetic and analgesic drugs without major complications.

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