scholarly journals Changes in headache characteristics with oral appliance treatment for obstructive sleep apnea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ji Woon Park ◽  
Sujay Mehta ◽  
Sandra Fastlicht ◽  
Alan A. Lowe ◽  
Fernanda R. Almeida
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Oxygen Saturation ◽  
Oral Appliance ◽  
Post Treatment ◽  
Mandibular Advancement ◽  
Headache Intensity ◽  
Obstructive Sleep ◽  
Before And After ◽  
Pre Treatment

AbstractChanges in headache characteristics in obstructive sleep apnea (OSA) patients following oral appliance treatment was investigated for the first time. Thirteen OSA patients with headaches treated with a mandibular advancement device were investigated. Level I polysomnography and Migraine Disability Assessment Questionnaire were completed before and after treatment. Various headache characteristics and concomitant conditions were analyzed. The patient was considered a headache responder when ≥ 30% reduction in headache frequency following treatment. Differences in headache and polysomnographic parameters were compared between headache responder groups. Eight patients (62%) were headache responders. Eleven patients (85%) before and 7 (54%) after treatment reported morning headaches. Significantly more patients had bilateral headache in the responder group before treatment (P = 0.035). The severest headache intensity (P = 0.018) at baseline showed a significant decrease in the headache responder group after treatment. The time spent in N2 (r = − 0.663, P = 0.014), REM sleep (r = 0.704, P = 0.007) and mean oxygen saturation (r = 0.566, P = 0.044) showed a significant correlation with post-treatment average headache intensity. Pre-treatment lower PLM index (r = − 0.632, P = 0.027) and higher mean oxygen saturation levels (r = 0.592, P = 0.043) were significantly correlated with higher post-treatment severest headache intensity. Treatment with an oral appliance is beneficial for many OSA patients with headaches. It should be considered as an alternative treatment in headache patients with mild to moderate OSA.

scholarly journals Markers of Myocardial Ischemia in Patients with Obstructive Sleep Apnea and Coronary Artery Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Misa Valo ◽  
Annette Wons ◽  
Albert Moeller ◽  
Claudius Teupe
Keyword(s):  
Coronary Artery Disease ◽  
Obstructive Sleep Apnea ◽  
Coronary Artery ◽  
Sleep Apnea ◽  
Myocardial Ischemia ◽  
Oxygen Saturation ◽  
St Segment ◽  
Obstructive Sleep ◽  
Before And After ◽  
Artery Disease

Obstructive sleep apnea (OSA) is characterized by intermittent hypoxia during sleep. We tested the hypothesis that nocturnal myocardial ischemia is detectable by ST segment depression and elevation of high sensitive troponin T (hsTrop T) and B-type natriuretic peptide (NT-proBNP) in patients with OSA and coexisting coronary artery disease (CAD). Twenty-one patients with OSA and CAD and 20 patients with OSA alone underwent in-hospital polysomnography. Blood samples for hsTrop T and NT-proBNP measurements were drawn before and after sleep. ST segment depression was measured at the time of maximum oxygen desaturation during sleep. The apnea-hypopnea-index (AHI), oxygen saturation nadir, and time in bed with oxygen saturation of ≤80% were similar in both groups. Levels of hsTrop T and NT-proBNP did not differ significantly before and after sleep but NT-proBNP levels were significantly higher in patients suffering from OSA and CAD compared to patients with OSA alone. No significant ST depression was found at the time of oxygen saturation nadir in either group. Despite the fact that patients with untreated OSA and coexisting CAD experienced severe nocturnal hypoxemia, we were unable to detect myocardial ischemia or myocyte necrosis based on significant ST segment depression or elevation of hsTrop T and NT-proBNP, respectively.

scholarly journals 0657 Impact of Treatment With Mandibular Advancement Oral Appliance on Respiratory Parameters, Sleep and Cardiometabolic Risk Factors of CPAP Non-Adherent Patients With Severe Obstructive Sleep Apnea

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A251-A251
Author(s):  
L Giannasi ◽  
M Gomes ◽  
L Oliveira ◽  
S Nacif ◽  
E Oliveira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cardiometabolic Risk ◽  
Oral Appliance ◽  
Cardiometabolic Risk Factors ◽  
Mandibular Advancement ◽  
Obstructive Sleep ◽  
The Impact

Abstract Introduction Obstructive sleep apnea (OSA) may trigger systemic changes linked to important cardiometabolic risk factors such as hypertension, stroke and diabetes II. As a life-threatening, multifactorial disorder, OSA demands a multiprofessional approach. The most common worldwide treatments are Continuous Positive Airway Pressure (CPAP) and Mandibular Advancement Oral Appliance (OAm). The aim of this study was to evaluate the impact of OAm treatment on CPAP non-adherent patients with severe OSA, comparing objective and subjective data between baseline and follow up. Methods A prospective study was carried out including non-adherent severe OSA patients, which were referred to OAm therapy evaluation. Patients presenting with snoring, gasping/choking during sleep, fatigue and daily sleepiness were evaluated by a sleep medicine specialist and the diagnosis of severe OSA with a basal polysomnography (PSG). All the patients were treated with a standard OAm (PMPositioner®). Baseline and Follow up (6 months) sleep parameters (PSG and Epworth Sleepiness Scale - ESS) were compared to assess treatment efficacy. Results Seventeen patients (9 with hypertension and 8 with hypertension + diabetes) met the inclusion criteria and 13 finished the protocol. After treatment with OAm the following parameters improved significantly: OSA severity (44.5±13.5 to 9.0±4.3, p≤0.001), ODI (46.8±11.6 to 12.1±9.1(p<0.05)), REM (18.4± 4.8 to 21.5± 2.9 (p<0.05)) and SaO2nadir (75.7± 9.4 to 87.0±3.6, p<0.001), ESS (p<0.005). Ten patients (58%) reported a reduction either in systolic and diastolic blood pressure with 3 of them (30%) reduced the hypertensive drug dose. Conclusion Our findings show that OAm is a safe and effective treatment option to CPAP non-adherent severe OSA patients. Furthermore OAm therapy had also a positive impact on cardiometabolic risk factors which are particularly relevant outcomes in OSA patients. Support State of Sao Paulo Research Support Foundation (FAPESP).

scholarly journals Correlation between Polysomnographic Parameters and Tridimensional Changes in the Upper Airway of Obstructive Sleep Apnea Patients Treated with Mandibular Advancement Devices

2021 ◽  
Vol 10 (22) ◽  
pp. 5255
Author(s):  
Sara Camañes-Gonzalvo ◽  
Rocío Marco-Pitarch ◽  
Andrés Plaza-Espín ◽  
Javier Puertas-Cuesta ◽  
Rubén Agustín-Panadero ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Oxygen Saturation ◽  
Upper Airway ◽  
Mandibular Advancement Device ◽  
Mandibular Advancement ◽  
Apnea Hypopnea Index ◽  
Percentage Increase ◽  
Obstructive Sleep ◽  
Mandibular Advancement Devices

Background. The effectiveness of mandibular advancement devices has been solidly demonstrated in the past. They are considered a valid alternative treatment to continuous positive airway pressure for patients with obstructive sleep apnea. Nevertheless, the relationship between polysomnographic parameters and the increase in the volume of the upper airway in patients with obstructive sleep apnea syndrome has not been clearly established so far. This study aimed to determine the impact of these oral appliances upon the volume of the airway after the device titration phase and correlate it with the degree of mandibular advancement and the improvement of polysomnographic parameters. Methods. All patients were diagnosed by polysomnography and were treated with a customized, titratable mandibular advancement device. Three-dimensional volumetric measurements were performed using cone beam computed tomography. Results. The present study included 45 patients diagnosed with obstructive sleep apnea hypopnea syndrome (mild in 23 patients, moderate in 11 and severe in 11). Forty-four percent of the patients presented with an apnea hypopnea index <5/h at the end of treatment. The volume of the upper airway increased an average of 4.3 ± 5.9 cm3, this represents a percentage increase of 20.9%, which was significantly correlated with an apnea hypopnea index and a minimum oxygen saturation improvement. Conclusions. The mandibular advancement device used was found to be effective in improving polysomnographic parameters. Moreover, the oral appliance was able to significantly increase the tridimensional dimensions of the upper airway. Moreover, this finding was correlated with a reduction in the apnea hypopnea index (p = 0.007) and an increase on minimum oxygen saturation (p = 0.033).

A Design of Oral Appliance for Obstructive Sleep Apnea (Preprint)

2020 ◽  
Author(s):  
Vikram Belkhode ◽  
Sharayu Nimonkar ◽  
Surekha Godbole ◽  
Pranali Nimonkar
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Adult Population ◽  
Oral Appliance ◽  
Epidemiological Studies ◽  
Mandibular Advancement ◽  
Obstructive Sleep ◽  
Alternative Treatment Option ◽  
Mandibular Advancement Devices ◽  
Maxillary Arch

BACKGROUND As per the current epidemiological studies, the prevalence of obstructive sleep apnea (OSA) among the adult population is very high. Oral appliances (OA) has emerged as the most recommended alternative treatment option for mild to moderate OSA. OBJECTIVE The objective of this article is to develop a new design of OA named “customized maxillary oral appliance”, for managing moderate obstructive sleep apnea (OSA) syndrome. METHODS The design proposed in this clinical technique is first of its kind that is fabricated on the maxillary arch. Customized maxillary oral appliance is developed by combining the principles of the three most popular OA’s used in OSA, namely soft palate lifters, tongue retaining devices, and mandibular advancement devices. RESULTS A new design of OA for the maxillary arch is proposed for managing moderate OSA. CONCLUSIONS Given the potential impact of OSA on general and mental health and the side effects of existing appliances there is a need for a new remedy to be introduced in the field of sleep medicine. This novel design can provide a new therapeutic op¬tion for patients with moderate OSA. CLINICALTRIAL Trial Registration: CTRI/2020/07/026936 Registered 31 July 2020, http://ctri.nic.in/Clinicaltrials/regtrial.php?modid=1&compid=19&EncHid=90265.33636

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