Sleep nasendoscopy: what benefit to the management of snorers?

1995 ◽  
Vol 109 (12) ◽  
pp. 1163-1165 ◽  
Author(s):  
Andrew E. Camilleri ◽  
Laxmi Ramamurthy ◽  
Philip H. Jones
Keyword(s):  
Success Rate ◽  
Obstructive Sleep Apnoea ◽  
Predictive Power ◽  
Sleep Apnoea ◽  
Grading System ◽  
Operative Results ◽  
Obstructive Sleep ◽  
Group A ◽  
Group B ◽  
Sleep Nasendoscopy

AbstractIt has been proposed that sleep nasendoscopy (SN) will improve the success rate of the uvulopalatopharyngoplasty operation by identifying those patients with palatal snoring. The aim of this study was to test the efficacy of SN in the management of snorers who do not have obstructive sleep apnoea. This study compared a group of 26 snorers managed without SN (group A) to a group of 27 snorers managed with SN (group B). The post-operative results of group A were 61 per cent cured, 27 per cent better and 8 per cent unchanged. Group B results were 76 per cent cured, 19 per cent better and 5 per cent unchanged. However, if patients with only palatal snoring had surgery, the results for group B would have been 94 per cent cured, 6 per cent better and 0 per cent unchanged (95 per cent C.I. of difference +0.14,+0.54, p = 0.017). The results confirm the predictive power of SN in identifying success following uvulopalatopharyngoplasty. A simple grading system is suggested to aid in treatment planning. Patients are divided into three categories on SN: palatal snorers, mixed snorers and non-palatal (tongue base) snorers. It is proposed that uvulopalatopharyngoplasty may cure palatal snorers but mixed snorers will need additional therapies to eliminate their snoring although uvulopalatopharyngoplasty may improve the symptoms.

scholarly journals Evaluation of a multicomponent grading system (Baveno classification) for obstructive sleep apnoea

2021 ◽  
pp. 00928-2020
Author(s):  
Winfried J. Randerath ◽  
Simon Herkenrath ◽  
Marcel Treml ◽  
Ludger Grote ◽  
Jan Hedner ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Treatment Decision ◽  
Sleep Apnoea ◽  
Grading System ◽  
Therapeutic Decisions ◽  
Obstructive Sleep ◽  
New Findings ◽  
Group A ◽  
Effect Of Treatment ◽  
A Minor

New findings on pathophysiology, epidemiology, and outcome have raised concerns on the relevance of the apnoea-hypopnoea index (AHI) in the classification of obstructive sleep apnoea (OSA) severity. Recently, a multicomponent grading system, decision integrating symptomatology and comorbidities (Baveno classification), was proposed to characterise OSA and to guide therapeutic decisions. We evaluated if this system reflects the OSA population, if it translates into differences in outcomes, and if the addition of AHI improves the scheme. 14 499 OSA patients from the European Sleep Apnoea Database (ESADA) cohort were analysed. The groups were homogeneously distributed and were found to clearly stratify the population with respect to baseline parameters. Differences in sleepiness and blood pressure between the groups were analysed in a subgroup of patients after 24–36 months of treatment. Group A (minor symptoms and comorbidities) did not demonstrate any effect of treatment on outcome. However, groups B (severe symptoms, minor comorbidities), C (minor symptoms, severe comorbidities) and D (severe symptoms and comorbidities) were associated with improvement in either or both parameters with treatment. The AHI is an essential prerequisite of the diagnosis. However, adding the AHI did not improve the classification. Rather, it was inferior with respect to guiding the treatment decision. Thus, the Baveno classification allows a better stratification of the OSA population and may provide a better guidance for therapeutic decisions in OSA.

Assessment of obstruction level and selection of patients for obstructive sleep apnoea surgery: an evidence-based approach

2009 ◽  
Vol 124 (1) ◽  
pp. 1-9 ◽  
Author(s):  
C Georgalas ◽  
G Garas ◽  
E Hadjihannas ◽  
A Oostra
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Clinical Syndrome ◽  
Limited Evidence ◽  
High Quality Evidence ◽  
Obstructive Sleep ◽  
Selection Of Patients ◽  
Sleep Nasendoscopy ◽  
Selection Of

AbstractIntroduction:Obstructive sleep apnoea has long been recognised as a clinical syndrome; however, high quality evidence on the effects of surgery for this condition is still missing. Despite this, a consensus seems to be evolving, albeit based on limited evidence, that surgery should be offered as a second line treatment to suitable patients with obstructive sleep apnoea.Aims:This article aims to assess the different methods of investigating upper airway obstruction in patients with obstructive sleep apnoea, in respect to these methods' relevance to surgical treatment, via a systematic review of the literature.Methods:The Cochrane Controlled Trials Register, Medline and EMBASE were searched from 1966 onwards. The search was performed in August 2008. A total of 2001 citations were retrieved.Results and conclusion:There is not yet a generally accepted way to assess surgical candidacy based on the level of obstruction. Better organised clinical studies with well defined endpoints are needed. In the meanwhile, it appears that sleep nasendoscopy, acoustic reflectometry and pressure catheters can all provide useful information, and their use may be decided upon based on the experience and resources available in individual departments.

scholarly journals A randomized controlled trial of an ambulatory approach versus the hospital-based approach in managing suspected obstructive sleep apnea syndrome

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
David S. Hui ◽  
Susanna S. Ng ◽  
Kin-Wang To ◽  
Fanny W. Ko ◽  
Jenny Ngai ◽  
...  
Keyword(s):  
Waiting Time ◽  
Sleep Apnea Syndrome ◽  
Sleep Apnoea ◽  
Sleep Study ◽  
Cpap Treatment ◽  
Home Based ◽  
Obstructive Sleep ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Comparisons of home-based versus hospital-based approach in managing patients with suspected obstructive sleep apnoea syndrome(OSAS). A prospective, controlled CPAP parallel study of new referrals with suspected OSAS randomized into group A) home-based or B) hospital-based approach. Following detection of AHI ≥ 15/hr by Embletta sleep study (group A) or polysomnography (group B), patients received CPAP for 3 months after an overnight autoCPAP titration at home or in hospital respectively. Modified intention-to-treat analysis of those with AHI ≥ 15/hr on CPAP (n = 86 vs 86) showed no difference in Epworth sleepiness score, the primary endpoint, but greater improvement in Sleep-Apnoea-Quality-of-Life-Index[difference 0.3,(95%CI 0.02, 0.6), p = 0.033] at 3 months in group A. The mean costs for the patients in group A and group B were HK$8479(989) and HK$22,248(2407) respectively. The mean difference between groups was HK$-13,769(USD 1770 equivalent) per patient with 95% CI. (−14324, −13213), p < 0.001. The waiting time of patients with AHI ≥ 15/hr who were started on CPAP treatment from the first clinic consultation to the diagnostic sleep test, autoCPAP titration, and CPAP treatment was 189.6, 148.8 and 145.0 days shorter in group A than group B respectively. Home-based approach is non-inferior to hospital-based approach in managing patients with suspected OSAS, with shorter waiting time, and substantial cost savings.

A novel multicomponent grading system for obstructive sleep apnoea severity applied in the ESADA cohort

2020 ◽  
Author(s):  
Winfried Randerath ◽  
Simon Herkenrath ◽  
Marcel Treml ◽  
Ludger Grote ◽  
Jan Hedner ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Grading System ◽  
Obstructive Sleep
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