scholarly journals New organisation for follow-up and assessment of treatment efficacy in sleep apnoea

2019 ◽  
Vol 28 (153) ◽  
pp. 190059 ◽  
Author(s):  
Monique Suarez-Giron ◽  
Maria R. Bonsignore ◽  
Josep M. Montserrat
Keyword(s):  
Sleep Apnoea ◽  
Field Application ◽  
Levels Of Care ◽  
Obstructive Sleep ◽  
Prevalent Disease ◽  
Improve Compliance ◽  
Primary Physicians ◽  
Compliance To Treatment ◽  
Sleep Laboratories

Obstructive sleep apnoea (OSA) is a highly prevalent disease, and there is an increased demand for OSA diagnosis and treatment. However, resources are limited compared with the growing needs for OSA diagnosis and management, and alternative strategies need to be developed to optimise the OSA clinical pathway. In this review, we propose a management strategy for OSA, and in general for sleep-disordered breathing, to be implemented from diagnosis to follow-up. For this purpose, the best current options seem to be: 1) networking at different levels of care, from primary physicians to specialised sleep laboratories; and 2) use of telemedicine. Telemedicine can contribute to the improved cost-effectiveness of OSA management during both the diagnostic and therapeutic phases. However, although the technology is already in place and different commercial platforms are in use, it is still unclear how to use telemedicine effectively in the sleep field. Application of telemedicine for titration of positive airway pressure treatment, follow-up to improve compliance to treatment through early identification and solution of problems, and teleconsultation all appear to be promising areas for improved OSA management.

Quality of life of children with sleep-disordered breathing treated with adenotonsillectomy

2010 ◽  
Vol 125 (2) ◽  
pp. 193-198 ◽  
Author(s):  
S M Powell ◽  
M Tremlett ◽  
D A Bosman
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnoea ◽  
Sleep Disordered Breathing ◽  
Sleep Apnoea ◽  
Life Assessment ◽  
Effect Sizes ◽  
Obstructive Sleep ◽  
Disordered Breathing

AbstractObjective:To assess the quality of life of UK children with sleep-disordered breathing undergoing adenotonsillectomy, by using the Obstructive Sleep Apnoea 18 questionnaire and determining score changes and effect sizes.Design:Prospective, longitudinal study.Setting:The otolaryngology department of a university teaching hospital in Northern England.Participants:Twenty-eight children for whom adenotonsillectomy was planned as treatment for sleep-disordered breathing, and who had either a clinical history consistent with obstructive sleep apnoea or a polysomnographic diagnosis.Main outcome measure:The Obstructive Sleep Apnoea 18 questionnaire, a previously validated, disease-specific quality of life assessment tool; changes in questionnaire scores and effect sizes were assessed.Methods:The Obstructive Sleep Apnoea 18 questionnaire was administered to each child's parent pre-operatively, then again at the follow-up appointment. Questionnaire scores ranged from 1 to 7. Score changes were analysed using the paired t-test; effect sizes were calculated using 95 per cent confidence intervals.Results:Complete data were obtained for 22 children (mean age, 61 months). Ten had undergone pre-operative polysomnography. Twenty-one children underwent adenotonsillectomy (one underwent tonsillectomy). Median follow up was eight weeks (interquartile range, six to 11 weeks). Following surgery, the overall mean score improvement was 2.6 (p < 0.0001) and the mean effect size 2.4 (95 per cent confidence interval 1.9 to 2.8). There were significant improvements in each of the individual questionnaire domains, i.e. sleep disturbance (mean score change 3.9, p < 0.0001), physical suffering (2.2, p < 0.0001), emotional distress (2.0, p = 0.0001), daytime problems (1.8, p = 0.0001) and caregiver concerns (2.6, p < 0.0001).Conclusion:In these children with sleep-disordered breathing treated by adenotonsillectomy, Obstructive Sleep Apnoea 18 questionnaire results indicated significantly improved mean score changes and effect sizes across all questionnaire domains, comparing pre- and post-operative data.

scholarly journals P094 CPAP Service Patient Experience Survey

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A51-A52
Author(s):  
R Mihai ◽  
K Ellis ◽  
N Verginis ◽  
M Davey ◽  
G Nixon
Keyword(s):  
Support Groups ◽  
Online Survey ◽  
Positive Airway Pressure ◽  
High Standard ◽  
Standard Of Care ◽  
Sleep Apnoea ◽  
Information Support ◽  
Obstructive Sleep ◽  
Experience Survey

Abstract Introduction Increasing numbers of children with obstructive sleep apnoea require continuous positive airway pressure (CPAP) treatment. We aimed to collect feedback from parents/carers about our CPAP education and follow-up programme. Methods An online survey link was texted to families of children starting outpatient CPAP from Jan 2019 -Feb 2021. Questions assessed satisfaction with the CPAP initiation process, including education by our nurse educator (NE), mask fitting, using equipment, accessing help, confidence using CPAP and follow up. Open-ended feedback was invited. Results 17/55 (31%) of eligible families responded. “Very satisfied” responses regarding CPAP education ranged from 76% (discussion of costs) to 94% (machine use and maintenance). All families felt confident starting CPAP at home. Two reported issues starting CPAP, but reported feeling fully supported by staff remotely to troubleshoot. All families were “somewhat” or “very satisfied” with NE follow-up, with 2 families more neutral about physician follow-up. Two families reported lower satisfaction (“somewhat dissatisfied” or neutral) with the range of paediatric masks, rather than with the mask fitting process itself. Of 14 general comments, 64% were positive (most common theme was high standard of care from the NE); 21% negative (lack of mask choices, location of consulting suites); and 15% neutral. Suggestions for improvement included financial support information, support groups and online consumable ordering. Discussion Families feel confident and well supported to commence outpatient CPAP, highlighting the care, knowledge and support provided by our team. Findings emphasize the importance of a dedicated NE. Suggestions provided will inform future service improvements.

scholarly journals Two months follow up of auto-CPAP treatment in patients with obstructive sleep apnoea

Thorax ◽  
1999 ◽  
Vol 54 (2) ◽  
pp. 147-149 ◽  
Author(s):  
A Boudewyns ◽  
V Grillier-Lanoir ◽  
M J Willemen ◽  
W A De Cock ◽  
P H Van de Heyning ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Cpap Treatment ◽  
Obstructive Sleep

scholarly journals Impact of surgical maxillomandibular advancement upon pharyngeal airway volume and the apnoea–hypopnoea index in the treatment of obstructive sleep apnoea: systematic review and meta-analysis

2019 ◽  
Vol 6 (1) ◽  
pp. e000402 ◽  
Author(s):  
Maria Giralt-Hernando ◽  
Adaia Valls-Ontañón ◽  
Raquel Guijarro-Martínez ◽  
Jorge Masià-Gridilla ◽  
Federico Hernández-Alfaro
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnoea ◽  
Meta Analysis ◽  
Sleep Apnoea ◽  
Eligibility Criteria ◽  
Pharyngeal Airway ◽  
Maxillomandibular Advancement ◽  
Subsequent Decrease ◽  
Obstructive Sleep

BackgroundA systematic review was carried out on the effect of surgical maxillomandibular advancement (MMA) on pharyngeal airway (PA) dimensions and the apnoea–hypopnoea index (AHI) in the treatment of obstructive sleep apnoea (OSA), with the aim of determining whether increased PA in the context of MMA is the main factor conditioning the subsequent decrease in AHI.MethodsA search was made of the PubMed, Embase, Google Scholar and Cochrane databases. A total of 496 studies were identified. The inclusion criteria were a diagnosis of moderate to severe OSA, MMA success evaluated by polysomnography, reporting of the magnitude of MMA achieved, PA increase and a minimum follow-up of 6 months.ResultsFollowing application of the eligibility criteria, eight articles were included. Metaregression analysis showed MMA to significantly increase both pharyngeal airway volume (PAV) (mean 7.35 cm3 (range 5.35–9.34)) and pharyngeal airway space (mean 4.75 mm (range 3.15–6.35)) and ensure a final AHI score below the threshold of 20 (mean 12.9 events/hour).ConclusionsAlthough subgroup analysis showed MMA to be effective in treating OSA, more randomised trials are needed to individualise the required magnitude and direction of surgical movements in each patient, and to standardise the measurements of linear and nonlinear PAV parameters.

Psychosis in Sleep Apnoea

1989 ◽  
Vol 23 (4) ◽  
pp. 571-573 ◽  
Author(s):  
Sing Lee ◽  
Helen F.K. Chiu ◽  
Char-Nie Chen
Keyword(s):  
Sleep Deprivation ◽  
Obstructive Sleep Apnoea ◽  
Complete Resolution ◽  
Slow Wave Sleep ◽  
Sleep Apnoea ◽  
Arterial Oxygen ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Intellectual Impairment ◽  
Obstructive Sleep

A 30-year-old man presenting with intellectual impairment and recurrent psychotic episodes was subsequently found to have suffered from a chronically untreated obstructive sleep apnoea syndrome. Polysomnography revealed sleep fragmentation, slow wave sleep deprivation and abnormal arterial oxygen desaturation. Tonsillectomy led to complete resolution of sleep apnoea and remission of psychosis at 2 years' follow-up, but his apparent intellectual impairment persisted. The limited literature on psychosis associated with sleep apnoea is briefly reviewed.

Laser-assisted uvulopalatoplasty: an assessment of a technique

1996 ◽  
Vol 110 (3) ◽  
pp. 232-236 ◽  
Author(s):  
Michael Wareing ◽  
David Mitchell
Keyword(s):  
Patient Satisfaction ◽  
Telephone Interview ◽  
Sleep Apnoea ◽  
Improve Outcome ◽  
Results Of Treatment ◽  
Obstructive Sleep ◽  
Operative Complications ◽  
Simple Snoring ◽  
Minor Side Effect

AbstractThe Kamami technique of laser-assisted uvulopalatoplasty has recently been introduced into British practice as an office-based multistage procedure for the treatment of snoring and, in certain cases, for obstructive sleep apnoea. We have treated 50 patients with simple snoring, with a minimum follow-up of six months. Six-month telephone interview follow-up has assessed partner and patient satisfaction, as well as willingness to undergo the procedure again. We have found the procedure easy to perform with no serious intra-operative complications. Thirty-four (68 per cent) of patients' partners have been definitely satisfied with the results of treatment, with 11 (22 per cent) definitely unsatisfied. However, only 25 of these 34 satisfied patients (76 per cent) would be prepared to undergo the treatment again with postoperative pain and discomfort cited as the reason in those who would not. The failure rate doubled between one and six months post-operatively. There have been no serious complications but a 40 per cent minor side-effect rate is noted. These results are discussed in the context of previously reported results, with consideration of future strategies to improve outcome.

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