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 The impact of oral appliance therapy with moderate mandibular advancement on obstructive sleep apnea and upper airway volume

2019 ◽  
Vol 24 (3) ◽  
pp. 865-873 ◽  
Author(s):  
Riitta Pahkala ◽  
J. Seppä ◽  
R. Myllykangas ◽  
J. Tervaniemi ◽  
V. M. Vartiainen ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Oral Appliance ◽  
Mandibular Advancement ◽  
Oral Appliance Therapy ◽  
Obstructive Sleep ◽  
The Impact

Mandibular advancement device use in obstructive sleep apnea: ORCADES study 5-year follow-up data

2021 ◽  
Author(s):  
Marie-Françoise Vecchierini ◽  
Valérie Attali ◽  
Jean-Marc Collet ◽  
Marie-Pia d'Ortho ◽  
Frederic Goutorbe ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Mandibular Advancement Device ◽  
Mandibular Advancement ◽  
Obstructive Sleep ◽  
Device Use

scholarly journals Long-term obstructive sleep apnea therapy: a 10-year follow-up of mandibular advancement device and continuous positive airway pressure

2020 ◽  
Vol 16 (3) ◽  
pp. 353-359 ◽  
Author(s):  
Julia A. M. Uniken Venema ◽  
Michiel H. J. Doff ◽  
Dilyana Joffe-Sokolova ◽  
Peter J. Wijkstra ◽  
Johannes H. van der Hoeven ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Mandibular Advancement Device ◽  
Mandibular Advancement ◽  
Obstructive Sleep

scholarly journals 0419 IL-6 Moderates the Association Between Obstructive Sleep Apnea Severity and Incident Alzheimer’s Disease: The Framingham Heart Study

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A160-A161
Author(s):  
A Baril ◽  
A S Beiser ◽  
S Redline ◽  
E R McGrath ◽  
H J Aparicio ◽  
...  
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Duration ◽  
Framingham Heart Study ◽  
Sleep Disturbances ◽  
Heart Study ◽  
Obstructive Sleep

Abstract Introduction Both sleep disturbances and inflammation are potential risk factors for Alzheimer’s disease (AD). However, it is unknown how inflammation and sleep interact together to influence the risk of developing AD dementia. Our objective was to evaluate whether interleukin-6 (IL-6) levels interact with sleep disturbances when predicting incident clinical AD. Methods We studied participants in the Framingham Heart Study Offspring cohort who completed in-home overnight polysomnography. Sleep characteristics were continuous and included sleep duration, wake after sleep onset (WASO), and apnea-hypopnea index (AHI). Participants were stratified into quartiles of IL-6 levels. Surveillance for incident AD dementia occurred over a mean follow-up of 13.4±5.4 years. Using Cox proportional hazards regression models, we tested the interaction of sleep measures by IL-6 quartiles on incident AD dementia. All analyses adjusted for age and sex and P<0.05 was considered significant. Results The final sample included 291 dementia-free participants at baseline (age 67.5±4.9 years, 51.6% men). Approximately one quarter of participants had obstructive sleep apnea (OSA; AHI>15) at baseline (median:6.2, Q1:2,3, Q3:14.3). We observed 33 cases of incident AD dementia during follow-up. Although no interaction was observed for either sleep duration or WASO with IL-6 levels, there was a significant interaction of AHI with IL-6 in predicting AD dementia (p=0.002). In the lowest IL-6 quartile, higher AHI was associated with an elevated risk of AD dementia (hazard ratio, 4.15 [95%CI, 1.42, 12.1], p=0.01) whereas no association between AHI and incident AD was observed in other IL-6 quartiles. Conclusion Our findings suggest that the pro-inflammatory cytokine IL-6 moderates the association between OSA and incident AD risk. The association between increasing OSA severity and incident AD was only observed in those with lower IL-6 levels, suggesting that this association might be especially apparent when no other confounding risk factors such as inflammation are present. Support The Framingham Heart Study is supported by contracts from the National Heart, Lung and Blood Institute, grants from the National Institute on Aging, and grants from the National Institute of Neurological Disorders and Stroke.

The impact of weight reduction in the prevention of the progression of obstructive sleep apnea: an explanatory analysis of a 5-year observational follow-up trial

2014 ◽  
Vol 15 (3) ◽  
pp. 329-335 ◽  
Author(s):  
Henri Tuomilehto ◽  
Juha Seppä ◽  
Matti Uusitupa ◽  
Markku Peltonen ◽  
Tarja Martikainen ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Weight Reduction ◽  
Explanatory Analysis ◽  
Obstructive Sleep ◽  
The Impact

scholarly journals Oral Appliance Versus Continuous Positive Airway Pressure in Obstructive Sleep Apnea Syndrome: A 2-Year Follow-up

SLEEP ◽  
2013 ◽  
Vol 36 (9) ◽  
pp. 1289-1296 ◽  
Author(s):  
Michiel H. J. Doff ◽  
Aarnoud Hoekema ◽  
Peter J. Wijkstra ◽  
Johannes H. van der Hoeven ◽  
James J. R. Huddleston Slater ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Sleep Apnea Syndrome ◽  
Oral Appliance ◽  
Obstructive Sleep ◽  
Apnea Syndrome
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