scholarly journals A short-term controlled trial of an adjustable oral appliance for the treatment of mild to moderate obstructive sleep apnoea

Thorax ◽  
1997 ◽  
Vol 52 (4) ◽  
pp. 362-368 ◽  
Author(s):  
K. A. Ferguson ◽  
T. Ono ◽  
A. A. Lowe ◽  
S. al-Majed ◽  
L. L. Love ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Controlled Trial ◽  
Oral Appliance ◽  
Sleep Apnoea ◽  
Short Term ◽  
Obstructive Sleep

Short-term weight gain after adenotonsillectomy in children with obstructive sleep apnoea: systematic review

2015 ◽  
Vol 130 (3) ◽  
pp. 214-218 ◽  
Author(s):  
M Van ◽  
I Khan ◽  
S S M Hussain
Keyword(s):  
Weight Gain ◽  
Obstructive Sleep Apnoea ◽  
Controlled Trial ◽  
Paediatric Population ◽  
Sleep Apnoea ◽  
Current Evidence ◽  
Short Term ◽  
Obstructive Sleep ◽  
Before And After ◽  
Randomised Controlled

AbstractBackground:Children with obstructive sleep apnoea commonly undergo adenotonsillectomy as first-line surgical treatment. This paper aimed to investigate whether this intervention was associated with weight gain after surgery in the paediatric population with obstructive sleep apnoea.Method:Two independent researchers systematically reviewed the literature from 1995 to 2014 for studies on patients who underwent adenotonsillectomy with weight-based measurements before and after surgery. The databases used were Ovid Medline, Embase and PubMed.Results:Six papers satisfied all inclusion criteria. Four of these papers showed a significant weight increase and the others did not. The only high quality, randomised, controlled trial showed a significant increase of weight gain at seven months follow up, even in patients who were already overweight before their surgery.Conclusion:The current evidence points towards an association between adenotonsillectomy and weight gain in patients with obstructive sleep apnoea in the short term.

New forehead device in positional obstructive sleep apnoea: a randomised clinical trial

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2020-216167
Author(s):  
Laura Hidalgo Armas ◽  
Sandra Ingles ◽  
Rafaela Vaca ◽  
Jose Cordero-Guevara ◽  
Joaquin Duran Carro ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Supine Position ◽  
Total Sleep Time ◽  
Controlled Trial ◽  
Randomised Clinical Trial ◽  
Sleep Time ◽  
Sleep Apnoea ◽  
Active Device ◽  
Link Type ◽  
Obstructive Sleep

RationaleApproximately 60% of the patients with obstructive sleep apnoea suffer from a positional effect, and approximately 25% of these patients present events only in the supine position.ObjectiveTo validate a new positional vibrating device and evaluate its efficacy in reducing the Apnoea–Hypopnoea Index and the total sleep time in the supine position without disturbing sleep.MethodsA total of 128 patients were recruited for this multicentre, prospective, parallel, randomised controlled trial and were distributed in three arms (general recommendations, inactive and active device). Full overnight polysomnography was performed at baseline and at 12 weeks. Anthropometric variables and sleep and quality of life questionnaires were collected at 4, 8 and 12 weeks.ResultsThe Apnoea-Hypopnoea Index decreased from 30.6 per hour to 20.4 per hour (p<0.001) in the active device (AD) group. In this group the reduction was 2.3-fold and 3.3-fold than the ones in the general recommendations (GR) and inactive device (ID) groups, respectively (p=0.014). Sleep time in supine position decreased 17.7%±26.3% in GR group (p<0.001), 13.0%±22.4% with ID group (p<0.001) and 21.0%±25.6% in the AD group (p<0.001). Furthermore, total sleep time increased significantly only in the AD group (22.1±57.5 min, p=0.016), with an increased percentage of time in the N3 (deep sleep) and N3+REM (rapid eye movement) stages, without sleep fragmentation.ConclusionThe device was effective in reducing the Apnoea–Hypopnoea Index and time spent in the supine position also in improving sleep architecture. Therefore, the device could be a good option for the management of patients with positional obstructive sleep apnoea.Trial registration detailsThe trial was registered at www.clinicaltrials.gov (NCT03336515).

P4404Prognostic value of novel nocturnal oxygen saturation metrics in patients with obstructive sleep apnoea and high cardiovascular event risk

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Linz ◽  
K Loffler ◽  
P Sanders ◽  
P Catcheside ◽  
C Anderson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Oxygen Saturation ◽  
Obstructive Sleep Apnoea ◽  
Controlled Trial ◽  
Characteristic Curve ◽  
Sleep Apnoea ◽  
Time Ratio ◽  
Event Risk ◽  
Obstructive Sleep

Abstract Aim To determine prognostic value of novel oximetry-derived metrics in patients with obstructive sleep apnoea (OSA) and high cardiovascular (CV) event risk. Methods and results Ancillary study of the Sleep Apnoea CV Endpoints (SAVE) randomised controlled trial, which investigated the effects of CPAP treatment on secondary CV event outcomes in 2687 participants with moderate-severe OSA and established CV disease. Associations between baseline characteristics, standard sleep and pulse oximetry-derived metrics, and CV outcomes were determined in Cox proportional hazards regression models stratified for treatment allocation. Metrics evaluated included: oxygen desaturation index, time below 90% oxygen saturation (SpO2), average SpO2across recordings (mean SpO2), across episodic desaturation events (desaturation SpO2), and baseline interpolated through episodic desaturation events (baseline SpO2); duration and desaturation/resaturation time ratio of episodic desaturation events; and mean and standard deviation of pulse rate. No SpO2 metric was associated with the composite outcome. Mean and baseline SpO2 were negatively associated with heart failure (hazard ratio [HR] 0.81, 95% confidence interval [CI] 0.69–0.95; P=0.009 and 0.78, 0.67–0.90; P=0.001, respectively) and myocardial infarction risk (0.86, 0.77–0.95; P=0.003 and 0.81, 0.73–0.90; P<0.001, respectively) and marginally positively associated with stroke risk (1.09, 1.00–1.20; P=0.065 and 1.13, 1.02–1.26; P=0.020, respectively). Desaturation duration and desaturation/resaturation time ratio, with established risk factors, predicted heart failure (area under the receiver-operating-characteristic curve 0.86, 95% CI 0.79–0.93). Conclusions Higher mean and baseline SpO2 were associated with reduced risk of heart failure and myocardial infarction, and small increases in stroke rate. Desaturation shape may have predictive utility for future CV events. Clinical trial registration: clinicaltrials (NCT00738179).

scholarly journals Obstructive sleep apnoea in a patient with chronic lymphocytic leukaemia

2019 ◽  
Vol 12 (7) ◽  
pp. e228763
Author(s):  
Gregory Paul Stimac ◽  
Asefa Jejaw Mekonnen
Keyword(s):  
Chronic Lymphocytic Leukaemia ◽  
Obstructive Sleep Apnoea ◽  
Lymphocytic Leukaemia ◽  
Oral Appliance ◽  
Sleep Apnoea ◽  
Caucasian Woman ◽  
Upper Airways ◽  
Airway Narrowing ◽  
Obstructive Sleep ◽  
Structural Abnormalities

A 69-year-old Caucasian woman presented with chronic lymphocytic leukaemia (CLL; stage 1-Rai System), significant oropharyngeal lymphoid enlargement, snoring and fatigue. Overnight polysomnography revealed moderately severe obstructive sleep apnoea (OSA), which was managed successfully with oral appliance therapy with resolution of snoring and daytime fatigue. Structural abnormalities of the upper airways are known to cause OSA. Airway narrowing can result from bony structural abnormalities, nasopharyngeal growth, soft tissue redundancy, macroglossia, malignant and benign growth of the upper aero-digestive tract, and adenotonsilar enlargement. Clinicians should be encouraged to consider a diagnosis of OSA in patients with CLL when they present with symptoms of worsening fatigue.

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