scholarly journals Tongue Function: An Underrecognized Component in the Treatment of Obstructive Sleep Apnea with Mandibular Repositioning Appliance

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Wei Wang ◽  
Changping Di ◽  
Skaff Mona ◽  
Lin Wang ◽  
Mark Hans
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Hypoglossal Nucleus ◽  
Quality Of Sleep ◽  
Obstructive Sleep ◽  
Function Recovery ◽  
Mandibular Repositioning Appliance ◽  
Oropharyngeal Exercises

Obstructive sleep apnea (OSA) is a common but still underrecognized disorder. A mandibular repositioning appliance (MRA) is used to treat OSA by advancing the mandible and thereby reducing the collapsibility of the upper airway. It has been found that an MRA increases the volume of the upper airway, especially the velopharyngeal area, in OSA patients. We hypothesize that this increase in the velopharyngeal volume is associated with an anterior displacement of the tongue, but likely not with a stretching of the soft tissue connecting the soft palate, lateral pharynx, palatopharyngeal arch, and mandible. Since the function and structure of the genioglossus and hypoglossal nerve are always abnormal in patients with OSA, the tongue does not always move simultaneously with the mandible when an MRA is being used. Oropharyngeal exercises, especially tongue exercises, can improve the quality of life of OSA patients, including reduction of daytime sleepiness and snoring, better quality of sleep, and partial decrease in the AHI. Further, in animal models, tongue exercise is also found to be effective in tongue function recovery and in the remodeling of the hypoglossal nucleus. We suggest that a combination of tongue exercises along with MRA is a promising approach for patients who do not respond to an MRA alone.

scholarly journals Sleep Quality and Quality of Life in COPD Patients with and without Suspected Obstructive Sleep Apnea

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Mohammad Ali Zohal ◽  
Zohreh Yazdi ◽  
Amir Mohammad Kazemifar ◽  
Parisa Mahjoob ◽  
Masomeh Ziaeeha
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Quality ◽  
Overlap Syndrome ◽  
Berlin Questionnaire ◽  
Quality Of Sleep ◽  
Copd Patients ◽  
Obstructive Sleep

Present study was designed to obtain association between sleep apnea with sleep quality and quality of life in COPD patients. This cross-sectional descriptive study was conducted on 139 patients with COPD in a chest clinic of a university hospital. All patients were evaluated by pulmonary function test for determination of severity of their disease. Also, Berlin questionnaire, Epworth sleepiness scale, Pittsburgh Sleep Quality Index, and St. George Respiratory questionnaires (SGRQ) were employed for assessment of patients. Analysis of data showed that quality of sleep was significantly correlated with quality of life (P<0.001). About half of the patients were at high risk for sleep apnea. The patients were divided into two groups according to the result of Berlin questionnaire. Significant differences were found between the groups for total score and each of three subscores of SGRQ suggesting worse quality of life in overlap syndrome (P<0.001). Also, patients with overlap syndrome had worse quality of sleep compared to patients without it (8.1±1.7versus6.2±2.3;P<0.001). Stepwise multiple regression analysis showed that severity of COPD, coexisting obstructive sleep apnea, and sleep quality accounted for the SGRQ significantly (r2(coefficient of determination) = 0.08, 0.21, and 0.18, resp.). It is recommended that patient with COPD be evaluated for sleep apnea and sleep disorders during routine examinations and followups.

scholarly journals Effect of oral appliances on quality of sleep in obstructive sleep apnea syndrome

2013 ◽  
Vol 59 (5) ◽  
pp. 294-300
Author(s):  
Takehiro ARISAKA ◽  
Chiemi Ito ◽  
Hitoshi MORISHITA ◽  
Yusuke TSUKAMOTO ◽  
Kazumichi SATO ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Oral Appliances ◽  
Quality Of Sleep ◽  
Obstructive Sleep ◽  
Apnea Syndrome

scholarly journals Relationships between Nocturia, Obstructive Sleep Apnea, and Quality of Sleep

2015 ◽  
Vol 6 (1) ◽  
pp. 28-34
Author(s):  
Eun Kyung Park ◽  
Jung Hyun Park ◽  
Jee Hyun Kim ◽  
Jung Im Choi ◽  
Kyounghye Kim ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Quality Of Sleep ◽  
Obstructive Sleep

Upper Airway Reconstructive Surgery Long-Term Quality-of-Life Outcomes Compared with CPAP for Adult Obstructive Sleep Apnea

2009 ◽  
Vol 141 (2) ◽  
pp. 257-263 ◽  
Author(s):  
Sam Robinson ◽  
Michael Chia ◽  
A. Simon Carney ◽  
Sharad Chawla ◽  
Penelope Harris ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Side Effects ◽  
Upper Airway ◽  
Cpap Therapy ◽  
Obstructive Sleep ◽  
Cpap Compliance

OBJECTIVE: To measure long-term quality-of-life (QOL) improvement following contemporary multilevel upper airway reconstruction surgery, compared with continuous positive airway pressure (CPAP) therapy. Secondary aims were to investigate factors determining clinical effectiveness and QOL impact of reported side effects. DESIGN: Cohort study. SUBJECTS AND METHODS: Consecutive, simultaneously treated adult patients with moderate-severe obstructive sleep apnea (OSA) having upper airway surgery (N = 77) or CPAP (N = 89) therapy were studied by questionnaire. Glasgow Benefit Inventory (GBI), change in snoring status and Epworth Sleepiness Scale (ESS), subjective CPAP compliance, and side effects in both groups were measured at mean ± SEM 44.12 ± 5.78 months (3.68 ± 0.48 years) after commencement of therapy. RESULTS: No significant difference was seen between surgical outcomes for GBI, snoring, or ESS and CPAP controls. Multivariate analysis showed reduction in Respiratory Disturbance Index (RDI) predicted postoperative snoring and ESS, but not GBI outcomes. Snoring control and GBI were related to CPAP compliance ( P < 0.001). CPAP side effects (reported in 26%) significantly reduced the QOL benefit of treatment, independent of compliance. Surgical complications (occurring in 44%) did not affect QOL treatment benefit. CONCLUSION: Patients with poor CPAP compliance and/or significant side effects of CPAP therapy (45% of cases in this series) should be evaluated for contemporary upper airway reconstructive surgery.

scholarly journals Positive Airway Pressure Prescription and Management for Patients with Obstructive Sleep Apnea

2020 ◽  
Vol 27 (2) ◽  
pp. 73-82
Author(s):  
Ji Ho Choi
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Upper Airway ◽  
Background Information ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) is characterized by repeated events of complete or partial upper airway obstruction during sleep and is a chronic sleep disorder that requires long-term comprehensive management. Positive airway pressure (PAP) is recommended for treatment of OSA in adults with excessive daytime sleepiness, decreased sleep-related quality of life, and comorbid hypertension. During PAP therapy, regular follow-up is continuously necessary to evaluate side effects or complications, compliance, and treatment effects such as OSA-related symptoms, quality of life, and consequences. This review provides knowledge about PAP-related background information, indications for PAP prescription including the Korean National Health Insurance criteria, optimal pressure, PAP modes, patient education and support, short-term and long-term management, interpretation of PAP uses, and alternative therapies.

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