Preferences and experiences regarding the treatment of obstructive sleep apnea with mandibular advancement splints - a cross-sectional pilot survey

CRANIO® ◽  
2021 ◽  
pp. 1-7
Author(s):  
Johannes Spille ◽  
Jonas Conrad ◽  
André Sengebusch ◽  
Jörg Wiltfang ◽  
Christof Dörfer ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Mandibular Advancement ◽  
Cross Sectional ◽  
Pilot Survey ◽  
Obstructive Sleep

Mechanical parameters determining pharyngeal collapsibility in patients with sleep apnea

2010 ◽  
Vol 109 (4) ◽  
pp. 1037-1044 ◽  
Author(s):  
Arie Oliven ◽  
Eran Kaufman ◽  
Rotem Kaynan ◽  
Ron Oliven ◽  
Uri Steinfeld ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Close Correlation ◽  
Mandibular Advancement ◽  
Cross Sectional ◽  
Pressure Flow ◽  
Pharyngeal Pressure ◽  
Obstructive Sleep ◽  
Mechanical Factors ◽  
Stimulation Of

The relative impact of mechanical factors on pharyngeal patency in patients with obstructive sleep apnea is poorly understood. The present study was designed to evaluate parameters of the “tube law” on pharyngeal pressure-flow relationships and collapsibility in patients with obstructive sleep apnea. We developed a mathematical model that considered the collapsible segment of the pharynx to represent an orifice of varying diameter. The model enabled us to assess the effects of pharyngeal compliance ( C), neutral cross-sectional area ( A o), external peripharyngeal pressure (Pex), and the resistance proximal to the site of collapse on flow mechanics and pharyngeal collapsibility [critical pressure (Pcrit)]. All parameters were measured in 15 patients with obstructive sleep apnea under propofol anesthesia, both at rest and during mandibular advancement and electrical stimulation of the genioglossus. The data was used both to confirm the validity of the model and to compare expected and actual relationships between the tube-law parameters and the pharyngeal pressure-flow relationship and collapsibility. We found a close correlation between predicted and measured Pcrit ( R = 0.98), including changes observed during pharyngeal manipulations. C and A o were closely and directly interrelated ( R = 0.93) and did not correlate with Pcrit. A significant correlation was found between Pex and Pcrit ( R = 0.77; P < 0.01). We conclude that the pharynx of patients with obstructive sleep apnea can be modeled as an orifice with varying diameter. Pharyngeal compliance and A o are closely interrelated. Pharyngeal collapsibility depends primarily on the surrounding pressure.

scholarly journals Patient satisfaction to evaluate the efficacy of mandibular advancement device in a treatment modality for mild to moderate sleep apnea patient in Indore Region

2021 ◽  
Vol 7 (3) ◽  
pp. 157-160
Author(s):  
Aanchal Verma ◽  
Sumeet Jain
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Obstructive Sleep Apnea Patient ◽  
Mandibular Advancement ◽  
Berlin Questionnaire ◽  
Age Group ◽  
Cross Sectional ◽  
Male And Female ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) represents the most severe syndrome associated with obstruction of the upper airway. People with obstructive sleep apnea (OSA) repeatedly stop breathing during their sleep for a moment or longer and as several as many times throughout one night. The Aim of study was to evaluate the efficacy of mandibular advancement devices in different age group, between male and female and according to body mass index in mild to moderate obstructive sleep apnea patient.cross sectional study. 30 patients of different gender and age group were selected with mild to moderate OSA and asked to fill the Berlin questionnaire for diagnosis of obstructive sleep apnea after obtaining the necessary consent.The analysis was done by using SPSS, IBM version 20.0. The level of significance was fixed at 5% and p ≤ 0.05. On evaluation of berlin questionnaire revealed that 83% of patients (including male and female) shows the significant improvement after the MAD treatment 16.7 % patient are not satisfied with the MAD. Study shows that the patient with OSA showed Positive Berlin Questionnaire before the MAD treatment and after 2 month it was revealed that MAD treatment showed statically significant improvement in OSA.

scholarly journals 0663 The Longterm Effect of CPAP Compared to Mandibular Advancement Device on Metabolic Profile in Mild Obstructive Sleep Apnea

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A253-A253
Author(s):  
S Togeiro ◽  
L S Oliveira ◽  
T M Guimaraes ◽  
G P Luz ◽  
G Coelho ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Metabolic Profile ◽  
Current Treatment ◽  
Mandibular Advancement Device ◽  
Mandibular Advancement ◽  
Control Group ◽  
Cross Sectional ◽  
Intention To Treat ◽  
Obstructive Sleep

Abstract Introduction Moderate and severe Obstructive Sleep Apnea (OSA) have been independently associated to dyslipidemia with controversial results of improvement with CPAP. Less evidence exists regarding this issue in mild OSA. A current treatment for mild OSA is Mandibular Advancement Device (MAD), however its effectiveness on metabolic profile needs to be compared to CPAP.Our aim was to compare MAD with CPAP and no treatment on metabolic profile during one year in mild OSA. Methods Cross sectional analyses included 79 mild OSA patients randomized in CPAP group (n: 31), MAD group (n. 25) and Control group (n: 23). Metabolic profile was investigated before and after 6 and months. Results Mean age: 47± 9 years, BMI: 28±3.7 kg/m AHI: 9.5±2.9/h. There were no differences in anthropometric data, total cholesterol (TCT) HDL-C, LDL-C, Triglycerides (TC) and glycated Hemoglobin (Hb1c) among groups. MAD and CPAP reduced AHI at 6 and 12 months (9.3 ± 5.2 to 4.2 ± 9.1 to 3.8 ± 12.6 / 10.0 ± 4.6 to 1.2 ± 9.9 to 1.7 ± 14.2, p: 0.01 respectively). BMI did not change in groups at 6 and 12 months. MAD adherence was higher than CPAP at 6 months (5.8 ± 2.8 hs/day vs 3.8 ± 3.0 hs/day; p: 0.01) and 12 months 5.7 ± 2.7 hs/day vs 3.8 ± 3.4 hs/day; p: 0.01). Despite of lower adherence than MAD, CPAP was effective in reduce TCT and LDL- CT at 6 and 12 months (Intention to treat analyses TCT: 189.3±51.4 mg/dl to 186.1±51.4 mg/dl to 174.6±51 mg/dl; p: 0.03 / 112.8±48.7 mg/dl to 110.5±48.7 mg/dl to 95.8±48.7mg/dl; p: 0.03 respectively), however HDL-C, TG and Hbc didn′t change. Conclusion Long term CPAP treatment was effective in reducing cholesterol in mild OSA. Support Associação Fundo Incentivo à Psicobiologia (AFIP) CAPES

scholarly journals Continuous Positive Airway Pressure-Mandibular Advancement Device Combination Therapy for Moderate-to-Severe Obstructive Sleep Apnea: A Preliminary Study

2021 ◽  
Author(s):  
Thyagaseely Sheela Premaraj ◽  
Jacob Stadiem ◽  
Shyamaly Arya Premaraj ◽  
Charles R. Davies ◽  
Matthew Dennis ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Daytime Sleepiness ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Mandibular Advancement Device ◽  
Mandibular Advancement ◽  
Severe Obstructive Sleep Apnea ◽  
Obstructive Sleep ◽  
The Mean

Abstract Objectives The purpose of this pilot study was to determine whether compliance to auto-adjusting positive airway pressure (APAP) improves with the addition of a mandibular advancement device (MAD). Secondary outcome measures included were APAP pressure, subjective daytime sleepiness, apnea–hypopnea index (AHI), and mask leaks. Setting and Sample Population Participants included were diagnosed with moderate-to-severe obstructive sleep apnea (OSA) and became noncompliant to prescribed APAP. Thirteen participants with a mean age of 61.6 years were recruited for this study. Materials and Methods All participants were given a MAD to use with their APAP. Parameters measured included APAP pressure, AHI, mask leak reported via ResMed AirViewTM software, and self-reported daytime sleepiness (Epworth Sleepiness Scale [ESS]). A paired two-sample for mean t-test was performed to determine significance. Results The mean difference of pre- and postintervention APAP compliance was 23.1%, which was statistically significant (p = 0.015). The mean APAP air pressures were unchanged. The difference between pre- and postintervention mean ESS scores was 1.4 and was statistically significant (p = 0.027). The mean difference between pre- and postintervention AHI values and mask leak showed no significant difference. Conclusion This study showed that combination of APAP-MAD therapy, for patients with moderate-to-severe OSA who were noncompliant to APAP use, significantly increased compliance with APAP therapy, and significantly decreased the daytime sleepiness of participants.

scholarly journals Inverse Cross-sectional and Longitudinal Relationships between Diabetic Retinopathy and Obstructive Sleep Apnea in Type 2 Diabetes

2021 ◽  
Vol 1 (1) ◽  
pp. 100011
Author(s):  
Jakob Grauslund ◽  
Lonny Stokholm ◽  
Anne S. Thykjær ◽  
Sören Möller ◽  
Caroline S. Laugesen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Obstructive Sleep Apnea ◽  
Diabetic Retinopathy ◽  
Sleep Apnea ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Longitudinal Relationships

scholarly journals Stress in obstructive sleep apnea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jasmine L. Wong ◽  
Fernando Martinez ◽  
Andrea P. Aguila ◽  
Amrita Pal ◽  
Ravi S. Aysola ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Depressive Symptoms ◽  
Sleep Apnea ◽  
Perceived Stress ◽  
Stress Reduction ◽  
Psychological Symptoms ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
General Anxiety Disorder ◽  
Obstructive Sleep

AbstractPeople with obstructive sleep apnea (OSA) often have psychological symptoms including depression and anxiety, which are commonly treated with anti-depression or anti-anxiety interventions. Psychological stress is a related symptom with different intervention targets that may also improve mental state, but this symptom is not well characterized in OSA. We therefore aimed to describe stress in relation to other psychological symptoms. We performed a prospective cross-sectional study of 103 people, 44 untreated OSA (mean ± s.d. age: 51.2 ± 13.9 years, female/male 13/31) and 57 healthy control participants (age: 46.3 ± 13.8 years, female/male 34/23). We measured stress (Perceived Stress Scale; PSS), excessive daytime sleepiness (Epworth Sleepiness Scale; ESS), depressive symptoms (Patient Health Questionnaire; PHQ-9), and anxiety symptoms (General Anxiety Disorder; GAD-7). We compared group means with independent samples t-tests and calculated correlations between variables. Mean symptom levels were higher in OSA than control, including PSS (mean ± s.d.: OSA = 15.3 ± 6.9, control = 11.4 ± 5.5; P = 0.002), GAD-7 (OSA = 4.8 ± 5.0, control = 2.1 ± 3.9; P = 0.02), PHQ-9 (OSA = 6.9 ± 6.1, control = 2.6 ± 3.8; P = 0.003) and ESS (OSA = 8.1 ± 5.3, control = 5.0 ± 3.3; P = 0.03). Similar OSA-vs-control differences appeared in males, but females only showed significant differences in PHQ-9 and ESS, not PSS or GAD-7. PSS correlated strongly with GAD-7 and PHQ-9 across groups (R = 0.62–0.89), and moderately with ESS. Perceived stress is high in OSA, and closely related to anxiety and depressive symptoms. The findings support testing stress reduction in OSA.

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