scholarly journals Patient satisfaction to evaluate the efficacy of mandibular advancement device in a treatment modality for mild to moderate sleep apnea patient in Indore Region

2021 ◽  
Vol 7 (3) ◽  
pp. 157-160
Author(s):  
Aanchal Verma ◽  
Sumeet Jain
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Obstructive Sleep Apnea Patient ◽  
Mandibular Advancement ◽  
Berlin Questionnaire ◽  
Age Group ◽  
Cross Sectional ◽  
Male And Female ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) represents the most severe syndrome associated with obstruction of the upper airway. People with obstructive sleep apnea (OSA) repeatedly stop breathing during their sleep for a moment or longer and as several as many times throughout one night. The Aim of study was to evaluate the efficacy of mandibular advancement devices in different age group, between male and female and according to body mass index in mild to moderate obstructive sleep apnea patient.cross sectional study. 30 patients of different gender and age group were selected with mild to moderate OSA and asked to fill the Berlin questionnaire for diagnosis of obstructive sleep apnea after obtaining the necessary consent.The analysis was done by using SPSS, IBM version 20.0. The level of significance was fixed at 5% and p ≤ 0.05. On evaluation of berlin questionnaire revealed that 83% of patients (including male and female) shows the significant improvement after the MAD treatment 16.7 % patient are not satisfied with the MAD. Study shows that the patient with OSA showed Positive Berlin Questionnaire before the MAD treatment and after 2 month it was revealed that MAD treatment showed statically significant improvement in OSA.

scholarly journals Turbulent Kinetic Energy of Flow During Inhale and Exhale to Characterize the Severity of Obstructive Sleep Apnea Patient

2021 ◽  
Author(s):  
W. M. Faizal ◽  
N. N.N Ghazali ◽  
C. Y. Khor ◽  
M. Z. Zainon ◽  
Norliza Binti Ibrahim ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Kinetic Energy ◽  
Turbulent Kinetic Energy ◽  
Upper Airway ◽  
Accurate Method ◽  
Obstructive Sleep Apnea Patient ◽  
Research Field ◽  
Cross Sectional ◽  
Obstructive Sleep

Abstract This paper aims to investigate and present the numerical investigation of airflow characteristics using Turbulent Kinetic Energy (TKE) to characterize the upper airway with obstructive sleep apnea (OSA) under inhale and exhale breathing conditions. The importance of TKE under both breathing conditions can show an accurate method in expressing the severity of flow in sleep disorder. Computational fluid dynamics are used to simulate the upper airway's airflow via steady-state Reynolds-averaged Navier-Stokes (RANS) with k–ω shear stress transport (SST) turbulence model. The three-dimensional (3D) airway model is created based on the CT scan images of an actual patient, meshed with 1.29 million elements using Materialise Interactive Medical Image Control System (MIMICS) and ANSYS software, respectively. Both high TKE and Rev were noticed around the region after the necking (smaller cross-sectional area) during the inhale and exhale breathing. The turbulent kinetic energy could be used as a valuable measure to identify the severity of OSA. This study is expected to provide a better understanding and clear visualization of the airflow characteristics during the inhale and exhale breathing in the upper airway of patients for the medical practitioners in the OSA research field.

Interacting effects of genioglossus stimulation and mandibular advancement in sleep apnea

2009 ◽  
Vol 106 (5) ◽  
pp. 1668-1673 ◽  
Author(s):  
Ron Oliven ◽  
Naveh Tov ◽  
Majed Odeh ◽  
Luis Gaitini ◽  
Uri Steinfeld ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Airway Pressure ◽  
Upper Airway ◽  
Combined Effect ◽  
Mandibular Advancement ◽  
Cross Sectional ◽  
Airway Patency ◽  
Obstructive Sleep ◽  
Critical Closing Pressure ◽  
Stimulation Of

Both mandibular advancement (MA) and stimulation of the genioglossus (GG) have been shown to improve upper airway patency, but neither one achieves the effect of continuous positive airway pressure (CPAP) treatment. In the present study we assessed the combined effect of MA and GG stimulation on the relaxed pharynx in patients with obstructive sleep apnea (OSA). We evaluated responses of upper airway pressure-flow relationships and endoscopically determined pharyngeal cross-sectional area to MA and electrical stimulation of the GG in 14 propofol-anesthetized OSA patients. Measurements were undertaken at multiple levels of CPAP, enabling calculation of the critical closing pressure (Pcrit), upstream resistance (Rus), and pharyngeal compliance. GG stimulation, MA, and the combination of both shifted the pressure:flow relationships toward higher flow levels, resulting in progressively lower Pcrit (from baseline of 2.9 ± 2.2 to 0.9 ± 2.5, −1.4 ± 2.9, and −4.2 ± 3.3 cmH2O, respectively), without significant change in Rus. ΔPcrit during GG stimulation was significantly larger during MA than under baseline conditions (−2.8 ± 1.4 vs. −2.0 ± 1.4 cmH2O, P = 0.011). Combining the effect of GG stimulation with MA lowered Pcrit below 0 in all patients and restored pharyngeal patency to a level that enabled flow above the hypopnea level in 10/14 of the patients. Velopharyngeal compliance was not affected by either manipulation. We conclude that the combined effect of MA and GG stimulation is additive and may act in synergy, preventing substantial flow limitation of the relaxed pharynx in most OSA patients.

Obstructive Sleep Apnea in Acromegaly and the Effect of Treatment: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 105 (3) ◽  
pp. e23-e31 ◽  
Author(s):  
Matteo Parolin ◽  
Francesca Dassie ◽  
Luigi Alessio ◽  
Alexandra Wennberg ◽  
Marco Rossato ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Meta Analysis ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Before And After ◽  
The Difference

Abstract Background Obstructive sleep apnea (OSA) is a common disorder characterized by upper airway collapse requiring nocturnal ventilatory assistance. Multiple studies have investigated the relationship between acromegaly and OSA, reporting discordant results. Aim To conduct a meta-analysis on the risk for OSA in acromegaly, and in particular to assess the role of disease activity and the effect of treatments. Methods and Study Selection A search through literature databases retrieved 21 articles for a total of 24 studies (n = 734). Selected outcomes were OSA prevalence and apnea-hypopnea index (AHI) in studies comparing acromegalic patients with active (ACT) vs inactive (INACT) disease and pretreatment and posttreatment measures. Factors used for moderator and meta-regression analysis included the percentage of patients with severe OSA, patient sex, age, body mass index, levels of insulin-like growth factor 1, disease duration and follow-up, and therapy. Results OSA prevalence was similar in patients with acromegaly who had ACT and INACT disease (ES = −0.16; 95% CI, −0.47 to 0.15; number of studies [k] = 10; P = 0.32). In addition, AHI was similar in ACT and INACT acromegaly patients (ES = −0.03; 95% CI, −0.49 to 0.43; k = 6; P = 0.89). When AHI was compared before and after treatment in patients with acromegaly (median follow-up of 6 months), a significant improvement was observed after treatment (ES = −0.36; 95% CI, −0.49 to −0.23; k = 10; P < 0.0001). In moderator analysis, the percentage of patients with severe OSA in the populations significantly influenced the difference in OSA prevalence (P = 0.038) and AHI (P = 0.04) in ACT vs INACT patients. Conclusion Prevalence of OSA and AHI is similar in ACT and INACT patients in cross-sectional studies. However, when AHI was measured longitudinally before and after treatment, a significant improvement was observed after treatment.

Mechanical parameters determining pharyngeal collapsibility in patients with sleep apnea

2010 ◽  
Vol 109 (4) ◽  
pp. 1037-1044 ◽  
Author(s):  
Arie Oliven ◽  
Eran Kaufman ◽  
Rotem Kaynan ◽  
Ron Oliven ◽  
Uri Steinfeld ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Close Correlation ◽  
Mandibular Advancement ◽  
Cross Sectional ◽  
Pressure Flow ◽  
Pharyngeal Pressure ◽  
Obstructive Sleep ◽  
Mechanical Factors ◽  
Stimulation Of

The relative impact of mechanical factors on pharyngeal patency in patients with obstructive sleep apnea is poorly understood. The present study was designed to evaluate parameters of the “tube law” on pharyngeal pressure-flow relationships and collapsibility in patients with obstructive sleep apnea. We developed a mathematical model that considered the collapsible segment of the pharynx to represent an orifice of varying diameter. The model enabled us to assess the effects of pharyngeal compliance ( C), neutral cross-sectional area ( A o), external peripharyngeal pressure (Pex), and the resistance proximal to the site of collapse on flow mechanics and pharyngeal collapsibility [critical pressure (Pcrit)]. All parameters were measured in 15 patients with obstructive sleep apnea under propofol anesthesia, both at rest and during mandibular advancement and electrical stimulation of the genioglossus. The data was used both to confirm the validity of the model and to compare expected and actual relationships between the tube-law parameters and the pharyngeal pressure-flow relationship and collapsibility. We found a close correlation between predicted and measured Pcrit ( R = 0.98), including changes observed during pharyngeal manipulations. C and A o were closely and directly interrelated ( R = 0.93) and did not correlate with Pcrit. A significant correlation was found between Pex and Pcrit ( R = 0.77; P < 0.01). We conclude that the pharynx of patients with obstructive sleep apnea can be modeled as an orifice with varying diameter. Pharyngeal compliance and A o are closely interrelated. Pharyngeal collapsibility depends primarily on the surrounding pressure.

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