scholarly journals Patient Powered Device for the Treatment of Obstructive Sleep Apnea

2010 ◽  
Vol 4 (2) ◽  
Author(s):  
Katya Christenson ◽  
Joseph Jacquemin ◽  
Steven Fannon ◽  
Davina Widjaja ◽  
Kathleen H. Sienko ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Negative Impact ◽  
Muscle Tone ◽  
Low Cost ◽  
Upper Airway ◽  
External Energy ◽  
Resource Limited ◽  
Obstructive Sleep ◽  
External Energy Source

Obstructive sleep apnea is a common sleep disorder in which throat muscles relax during sleep, causing the upper airway to close. As a result, breathing ceases until a brief awakening restores the muscle tone and reopens the airway. Untreated sleep apnea contributes to cognitive, cardiovascular, and metabolic morbidity and has substantial negative impact on an individual’s quality of life. Treatment most commonly consists of nightly use of a nasal mask connected to a continuous positive airway pressure (CPAP) machine. The CPAP machine splints the upper airway open by supplying positive air pressure. However, the machine is expensive, requires electricity, and has suboptimal portability, noise, and aesthetics. The aim of this work was to develop a low-cost, lightweight, quiet, and mechanical CPAP machine that would function without an external energy source in resource-limited settings.

scholarly journals CPAP compliance in patients with moderate to severe obstructive sleep apnea from three centers in South India

2017 ◽  
Vol 5 (11) ◽  
pp. 4886
Author(s):  
Mathew Ninan ◽  
Balachandran J.
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Low Cost ◽  
Compliance Rate ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Problem Area ◽  
High Rate ◽  
Positive Pressure ◽  
Obstructive Sleep

Background: Obstructive sleep apnea syndrome (OSAS) is a common sleep related breathing disorder, characterised by frequent interruptions of breathing during sleep resulting in arousals and a sympathetic overdrive. The most effective treatment for patients with significant sleep apnea has been a device which delivers positive pressure on the upper airway to act as a physiological splint thus preventing collapse of the upper airway (CPAP) to be used while sleeping. However patient compliance with CPAP use has always been a problem area. Many studies published show a compliance rate between 30% to 80% from different parts of the globe. We wanted to assess compliance with CPAP in our patient population.Methods: A retrospective telephonic interview of patients who had been diagnosed with moderate to severe OSAS from 3 centers in Kerala.Results: In present study we found a net compliance rate of only 14.7% and the primary reason for this high rate of non-compliance was the relatively high cost of the CPAP.Conclusions: The compliance with CPAP in our study was very low and the most cited reason was the cost of the device. In patients who brought the device the compliance rate was similar to studies from western countries. To increase compliance with CPAP in patients with OSAS may require innovative thinking to reduce the upfront cost of the device (e.g. renting or leasing devices, providing options for paying in instalments and also more importantly focussing on low cost devices (CPAP).

Hypoglossal nerve stimulation [HGNS] for Obstructive Sleep Apnea [OSA] treatment – a review

2017 ◽  
Vol 6 (3) ◽  
pp. 66-71
Author(s):  
Małgorzata Bilińska ◽  
Kazimierz Niemczyk
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Hypoglossal Nerve ◽  
Muscle Tone ◽  
Upper Airway ◽  
Western Society ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Osa Treatment ◽  
Oncologic Diseases

Obstructive sleep apnea (OSA) is characterized by recurrent periods of upper airway obstruction (hypopneas and apneas) during sleep. It leads to repeated oxyhemoglobin desaturations, nocturnal hypercapnia, and arousals. Common symptoms include loud snoring with breathing interruptions. Excessive daytime sleepiness and cognitive impairment occur. Obstructive sleep apnea is a major cause of morbidity and mortality in Western society. Its association with an increased risk of development and progression of neurocognitive, metabolic, cardiovascular and oncologic diseases and complications is well described. The significant factor in OSA pathogenesis is reduced muscle tone in the tongue and upper airway. In the recent years, devices providing neurostimulation of the hypoglossal nerve (HGNS) were developed as an alternative for noncompliant CPAP (continuous positive airway pressure) patients. Clinical trials suggest that electrical stimulation of the hypoglossal nerve is effective. This is considered to be one of the targets of neurostimulation in the treatment of obstructive sleep apnea (OSA).

Tracheal hysteresis in sleep apnea

1989 ◽  
Vol 67 (4) ◽  
pp. 1349-1353 ◽  
Author(s):  
I. Katz ◽  
N. Zamel ◽  
A. S. Slutsky ◽  
A. S. Rebuck ◽  
V. Hoffstein
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Muscle Tone ◽  
Upper Airway ◽  
Lung Parenchyma ◽  
Apnea Hypopnea Index ◽  
Cross Sectional ◽  
Acoustic Reflection ◽  
Obstructive Sleep ◽  
Pharyngeal Muscles

The collapsibility of pharyngeal walls, characteristic of patients with obstructive sleep apnea, likely results from reduced tone of the pharyngeal muscles. This reduction in the upper airway muscle tone may not end at the pharynx but may extend further distally, e.g., into the trachea. Because tracheal tone cannot be measured directly in conscious humans, we inferred the tone from the relative hysteresis of the tracheal area compared with the lung. Relative hysteresis was measured by plotting the cross-sectional area of a tracheal segment obtained by the acoustic reflection technique vs. lung volume. All measurements were performed during wakefulness. We found that in 42 patients with obstructive sleep apnea (apnea/hypopnea index greater than 10), relative hysteresis of the proximal trachea was predominantly clockwise, i.e., smaller than that of the lung parenchyma; in the 33 nonapneic patients (apnea/hypopnea index less than or equal to 10), it was predominantly counter-clockwise, i.e., larger than that of the lung parenchyma. For the distal trachea all patients, apneic and nonapneic, had similar, clockwise, relative hysteresis. We conclude that reduction in the upper airway muscle tone in patients with obstructive sleep apnea extends into the trachea.

Continuous Wavelet Analysis of the Breathing Sounds of Obstructive Sleep Apnea Patients and Normal Subjects during Wakefulness

2014 ◽  
Vol 622 ◽  
pp. 45-50 ◽  
Author(s):  
R. Premkumar ◽  
Chokkalingam Arun ◽  
Ramakrishnan Sai Divya
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Low Cost ◽  
Upper Airway ◽  
Normal Subjects ◽  
Continuous Wavelet ◽  
Blood Oxygen ◽  
Blood Oxygen Saturation ◽  
Non Invasive ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) is the most common type of sleep apnea and is caused by obstruction of the upper airway. Its distinctive feature is occurrence of repetitive pauses in breathing during sleep, due to intermittent relaxing and blocking of the patients airway by the throat muscles. Continuous such actions might narrow down the throat or may completely block it. These actions cause more difference in breathing sounds and are usually associated with a reduction in blood oxygen saturation. The breathing sounds of the patients with and without obstructive sleep apnea were recorded using a non-invasive, low-cost sensor during wakefulness in supine (lying) position and Continuous wavelet 1-D analysis was performed on those signals.

S300 – Comparison of Endoscopy Diagrams for Obstructive Sleep Apnea

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P175-P175
Author(s):  
Masami Nakajima ◽  
B Tucker Woodson
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Muscle Tone ◽  
False Negative ◽  
Upper Airway ◽  
Endoscopic Examination ◽  
Exact Matching ◽  
Airway Collapse ◽  
Obstructive Sleep ◽  
Muscle Groups

Objectives Most methods of waking and sedated sleep endoscopy evaluating the upper airway in obstructive sleep apnea inconsistently predict surgical results. Goals of exam have been to identify levels of obstruction or levels of tissue vibration. Examinations provide little information on airway structure. A novel method of describing airway collapse using airway structures has been developed. The objectives of this study are to compare sleep and wake examination: 1) during inspiration, and 2) expiration. Methods A retrospective review evaluated waking and sedated clinical endoscopic endoscopy. Clinical endoscopic examination was performed supine at end expiration. Sedated endoscopy used propofol anesthesia evaluated the airway during both inspiration, expiration, and with elimination of airway mechanoreceptors. Defined structural butressess included salpingo/palatopharyngeus, levator, and uvular muscle groups for the epi-pharynx and the epiglottis, lateral hypopharynx, vallecular and proximal tongue base for the hypopharynx. Structures were scored on 3 and 4 point scales with agreement indicating exact matching. Results Severity of obstruction scored higher on sedated exam than clinical exam. Structural agreement in epipharynx was 52%, 29%, and 24%, and in hypopharynx, 48%,24%, and 38%. False negative and positive assessment occurred in epipharynx (levator 30% and uvula 40%) but not in hypopharynx. Conclusions Consistent with a greater loss of muscle tone during sleep, exact agreement between wake and sleep exams was low, however, supine end expiratory exam predicted patterns of airway collapse in hypopharynx. Pattern of collapse in epipharynx is confounded by ventilation during wake.

scholarly journals Obstructive Sleep Apnea: Emerging Treatments Targeting the Genioglossus Muscle

2019 ◽  
Vol 8 (10) ◽  
pp. 1754 ◽  
Author(s):  
Olga Mediano ◽  
Sofia Romero-Peralta ◽  
Pilar Resano ◽  
Irene Cano-Pumarega ◽  
Manuel Sánchez-de-la-Torre ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Muscle Tone ◽  
Treatment Strategies ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Compensatory Response ◽  
Dilator Muscle ◽  
Obstructive Sleep ◽  
Osa Treatment

Obstructive sleep apnea (OSA) is characterized by repetitive episodes of upper airway obstruction caused by a loss of upper airway dilator muscle tone during sleep and an inadequate compensatory response by these muscles in the context of an anatomically compromised airway. The genioglossus (GG) is the main upper airway dilator muscle. Currently, continuous positive airway pressure is the first-line treatment for OSA. Nevertheless, problems related to poor adherence have been described in some groups of patients. In recent years, new OSA treatment strategies have been developed to improve GG function. (A) Hypoglossal nerve electrical stimulation leads to significant improvements in objective (apnea-hypopnea index, or AHI) and subjective measurements of OSA severity, but its invasive nature limits its application. (B) A recently introduced combination of drugs administered orally before bedtime reduces AHI and improves the responsiveness of the GG. (C) Finally, myofunctional therapy also decreases AHI, and it might be considered in combination with other treatments. Our objective is to review these therapies in order to advance current understanding of the prospects for alternative OSA treatments.

scholarly journals Muscular Assessment in Patients With Severe Obstructive Sleep Apnea Syndrome: Protocol for a Case-Control Study (Preprint)

2021 ◽  
Author(s):  
Paz Francisca Borrmann ◽  
Carlos O'Connor-Reina ◽  
Jose M Ignacio ◽  
Elisa Rodriguez Ruiz ◽  
Laura Rodriguez Alcala ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Muscle Tone ◽  
Therapeutic Option ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Case Control ◽  
Control Group ◽  
Myofunctional Therapy ◽  
Obstructive Sleep

BACKGROUND Myofunctional therapy is currently a reasonable therapeutic option to treat obstructive sleep apnea-hypopnea syndrome (OSAHS). This therapy is based on performing regular exercises of the upper airway muscles to increase their tone and prevent their collapse. Over the past decade, there has been an increasing number of publications in this area; however, to our knowledge, there are no studies focused on patients who can most benefit from this therapy. OBJECTIVE This protocol describes a case-control clinical trial aimed at determining the muscular features of patients recently diagnosed with severe OSAHS compared with those of healthy controls. METHODS Patients meeting set criteria will be sequentially enrolled up to a sample size of 40. Twenty patients who meet the inclusion criteria for controls will also be evaluated. Patients will be examined by a qualified phonoaudiologist who will take biometric measurements and administer the Expanded Protocol of Orofacial Myofunctional Evaluation with Scores (OMES), Friedman Staging System, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index questionnaires. Measures of upper airway muscle tone will also be performed using the Iowa Oral Performance Instrument and tongue digital spoon devices. Evaluation will be recorded and reevaluated by a second specialist to determine concordance between observers. RESULTS A total of 60 patients will be enrolled. Both the group with severe OSAHS (40 patients) and the control group (20 subjects) will be assessed for differences between upper airway muscle tone and OMES questionnaire responses. CONCLUSIONS This study will help to determine muscle patterns in patients with severe OSAHS and can be used to fill the gap currently present in the assessment of patients suitable to be treated with myofunctional therapy. CLINICALTRIAL ISRCTN Registry ISRCTN12596010; https://www.isrctn.com/ISRCTN12596010 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/30500

Aerodynamics Analysis of the Impact of Nasal Surgery on Patients with Obstructive Sleep Apnea and Nasal Obstruction

ORL ◽  
2021 ◽  
pp. 1-8
Author(s):  
Lifeng Li ◽  
Demin Han ◽  
Hongrui Zang ◽  
Nyall R. London
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nasal Obstruction ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Nasal Surgery ◽  
Subjective Sleep Quality ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
The Impact

<b><i>Objective:</i></b> The purpose of this study was to evaluate the effects of nasal surgery on airflow characteristics in patients with obstructive sleep apnea (OSA) by comparing the alterations of airflow characteristics within the nasal and palatopharyngeal cavities. <b><i>Methods:</i></b> Thirty patients with OSA and nasal obstruction who underwent nasal surgery were enrolled. A pre- and postoperative 3-dimensional model was constructed, and alterations of airflow characteristics were assessed using the method of computational fluid dynamics. The other subjective and objective clinical indices were also assessed. <b><i>Results:</i></b> By comparison with the preoperative value, all postoperative subjective symptoms statistically improved (<i>p</i> &#x3c; 0.05), while the Apnea-Hypopnea Index (AHI) changed little (<i>p</i> = 0.492); the postoperative airflow velocity and pressure in both nasal and palatopharyngeal cavities, nasal and palatopharyngeal pressure differences, and total upper airway resistance statistically decreased (all <i>p</i> &#x3c; 0.01). A significant difference was derived for correlation between the alteration of simulation metrics with subjective improvements (<i>p</i> &#x3c; 0.05), except with the AHI (<i>p</i> &#x3e; 0.05). <b><i>Conclusion:</i></b> Nasal surgery can decrease the total resistance of the upper airway and increase the nasal airflow volume and subjective sleep quality in patients with OSA and nasal obstruction. The altered airflow characteristics might contribute to the postoperative reduction of pharyngeal collapse in a subset of OSA patients.

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