scholarly journals An Anti-Snoring Oral Appliance to Reduce Simple Snoring as a Non-Invasive Method for Management of Snoring: A Case Report and Literature Review

2021 ◽  
Author(s):  
Maryam Edalatifard ◽  
Maryam Albaji ◽  
Besharat Rahimi
Keyword(s):  
Case Report ◽  
Oral Appliance ◽  
Oral Appliances ◽  
Upper Airways ◽  
Airway Patency ◽  
Non Invasive ◽  
Obstructive Sleep ◽  
Invasive Method ◽  
Airways Resistance ◽  
Simple Snoring

Background and Objective: Simple snoring affects millions of people and their partners in the world and it indicates increased upper airways resistance and pharyngeal collapsibility. Snoring, particularly loud and habitual, may indicate obstructive sleep apnea (OSA). Case Report: The presenting patient was a middle-aged man with chief compliant of snoring, who was diagnosed with simple snoring after undergoing an overnight polysomnography (PSG). By using a simple oral appliance that retracted the tongue and improved airway patency, snoring improved completely. Conclusion: Simple snoring is a common condition and after excluding OSA, particularly in suspected patients, it can be managed by some instructions and interventions such as using available oral appliances.

Randomized Trial of 2 Self-Titrated Oral Appliances for Airway Management

2020 ◽  
pp. 002203452095697
Author(s):  
E. Schneiderman ◽  
P. Schramm ◽  
J. Hui ◽  
P. D. Wilson ◽  
P. Moura ◽  
...  
Keyword(s):  
Crossover Trial ◽  
Positive Airway Pressure ◽  
Mouth Opening ◽  
Oral Appliance ◽  
Oral Appliances ◽  
Pressure Therapy ◽  
Randomized Crossover Trial ◽  
Obstructive Sleep ◽  
Respiratory Event ◽  
Test Population

The effectiveness and predictability of 2 different oral appliance (OA) designs to reduce the respiratory event index (REI) in moderate and severe obstructive sleep apnea (OSA) patients requires elucidation. The primary aim of the trial was to determine if 2 widely used midline-traction and bilateral-thrust OA designs differ in effectiveness to reduce the REI within a single test population categorized by OSA severity. Moderate and severe adult OSA patients, who were previously prescribed continuous positive airway pressure therapy (CPAP) but were dissatisfied with it ( n = 56), were studied by home-polygraphy in a randomized crossover trial using either midline-traction with restricted mouth opening (MR) or bilateral thrust with opening permitted (BP) design OAs. OAs were used nightly for 4 wk (T2) followed by a 1-wk washout period, then 4 wk (T4) using the alternate OA. REI and oxygen saturation (SaO2) were primary outcomes, while predictability and efficacy comparison of the 2 OAs were secondary outcomes. Thirty-six participants had used MR and BP OAs during both 4-wk study legs. Twenty (55.6%) MR OA-using participants, 25 (69.4%) BP OA-using participants, and 16 (44.4%) participants using both OAs had significant REI reductions. Overall baseline (T0) median REI (interquartile range) of 33.7 (20.7–54.9) was reduced to 18.0 (8.5–19.4) at T2 and to 12.5 (8.2–15.9) at T4 ( P < 0.001). Comparison of the 2 sequence groups’ (MR-BP and BP-MR) REI showed the median differences between T0 and T2 and T4 were highly significant ( P < 0.001). Regression analysis predicted about half of all users will have REIs between 8 and 16 after 2 mo. Baseline overjet measures >2.9 mm predicted greater OA advancement at T4. Mean and minimum SaO2 did not change significantly from T0 to T2 or T4. MR and BP OA designs similarly attenuated REI in moderate and severe OSA individuals who completed the 8-wk study protocol with greater REI reduction in those with severe OSA (ClinicalTrials.gov NCT03219034).

scholarly journals Effect of mandibular position achieved using an oral appliance on genioglossus activity in healthy adults during sleep

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Michikazu Matsuda ◽  
Toru Ogawa ◽  
Ratri M. Sitalaksmi ◽  
Makiko Miyashita ◽  
Toshimi Ito ◽  
...  
Keyword(s):  
Muscle Activity ◽  
Vertical Displacement ◽  
Oral Appliance ◽  
Airway Patency ◽  
Test Conditions ◽  
Obstructive Sleep ◽  
Mandibular Position ◽  
Vertical Displacements ◽  
The Relationship ◽  
Airflow Sensor

Abstract Background Oral appliances (OAs) are generally designed to displace the mandible anteriorly and downward, to increase the airway patency. The present study aimed to examine the relationship between genioglossus (GG) muscle activity and mandibular position, considering both anterior and vertical displacements during sleep. Methods Seven healthy male adults aged 29.4 ± 1.99 years were evaluated. Maxillary and mandibular OAs were fabricated from 2-mm-thick resin plates with pressure-welding. The activity of the left GG was recorded using two silver ball electrodes attached to the lingual edge of the mandibular OA. Respiratory status and right masseter muscle activity were measured by an airflow sensor and surface electrodes, respectively. Electroencephalography was used to determine the sleep status. Stage 2 (the second stage of sleep) was defined as the state of sleeping. Four test conditions with different mandibular positions (0 and 50% anterior protrusion) and bite openings (4 mm and 12 mm) were examined. Results GG activity in SL4A (4 mm bite opening, 50% protrusion during sleep) and SL12 (12 mm bite opening, 0% protrusion during sleep) were significantly higher than that in SL4 (4 mm bite opening, 0% protrusion during sleep). Respiratory volume did not significantly differ between all test conditions. Conclusion GG activity is influenced not only by anterior protrusion of the mandible but also by vertical displacement during sleep. Thus, when determining the effectiveness of intraoral appliances in the treatment of obstructive sleep apnea, both protrusion and the size of the mandibular opening should be evaluated and taken into account.

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.

Hearing loss in mild OSAS and simple snoring patients

2017 ◽  
Vol 71 (2) ◽  
pp. 11-15
Author(s):  
Maria Carla Spinosi ◽  
Francesca D'Amico ◽  
Giulio Passali ◽  
Cemal Cingi ◽  
Hugo Rodriguez ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Pathological Condition ◽  
Sleep Apnea Syndrome ◽  
Study Groups ◽  
Control Group ◽  
Auditory Function ◽  
Upper Airways ◽  
Obstructive Sleep ◽  
The Impact ◽  
Simple Snoring

Introduction Obstructive Sleep Apnea Syndrome (OSAS) is characterized by recurrent episodes of prolonged partial or complete obstruction of the upper airways. Several study groups studied the effect of snoring and OSAS on auditory function, showing an increase in the incidence of hearing loss in apneic patients, an earlier onset and/or a degree of hearing loss deeper than in peers. The aim of our study is to evaluate the audiological performance of a population of simple-snoring patients and patients suffering from mild OSAS, and the impact that such pathological condition can have on the auditory function, considering the significant levels of chronic noise. Materials and Methods Data was collected by analyzing audiometric exams on snoring patients and a control group of non-snoring patients. Our study included simple snoring patients without OSAS (AHI < 5) or with low level of OSAS (5< AHI < 15). Possible hearing loss was classified in a crescent scale (A-B-C-D-E), from greater to minor auditory performance, according to the indications of the national protocol of occupational medicine for evaluation of hearing loss in patients exposed to chronic noise. Results We have found independence between simple snorers, mild-OSAS snorers and non-snoring patients compared to the scale of hearing performance classification. Conclusions Our results show a distribution of hearing loss in the different groups that appear independent of the presence or absence of snoring, complicated or uncomplicated by mild OSAS.

scholarly journals Computational fluid dynamics simulation of changes in the morphology and airflow dynamics of the upper airways in OSAHS patients after treatment with oral appliances

2019 ◽  
Author(s):  
Song Baolong ◽  
Li Yibo ◽  
Sun Jianwei ◽  
Qi Yizhe ◽  
Li Peng ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Upper Airway ◽  
Biomechanical Properties ◽  
Dynamics Simulation ◽  
Ct Scans ◽  
Oral Appliances ◽  
Upper Airways ◽  
Obstructive Sleep ◽  
Airway Morphology

AbstractObjectivesTo explore the changes of morphology and internal airflow in upper airways (UA) after the use of oral appliances (OAs) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), and investigate the mechanisms by which OAs function as a therapy for OSAHS.MethodsEight OSAHS patients (all male, aged 37-58, mean age 46.25) underwent CT scans before and after OA use. Then, computational fluid dynamics(CFD) models were built on the base of the CT scans using Mimics and ANSYS ICEM CFD software. The internal airflow of the upper airways was simulated using ANSYS-FLUENT and the results were analyzed using ANSYS-CFD-Post. The data were analyzed to identify the most important changes of biomechanical properties between patients with and without OA intervention. Upper airway morphology and the internal airflow changes were compared using t-tests and Spearman correlation coefficient analysis.ResultsThe narrowest area of upper airways was found to be located in the lower bound of velopharynx, where the volume and pressure were statistically significantly increased (P<0.05) and the air velocity was statistically significantly decreased (P<0.05) in the presence of the OA(P<0.05). After wearing OA, pharyngeal resistance was significantly decreased (P<0.05), from 290.63 to 186.25Pa/L, and the airflow resistance of the pharynx has reduced by 35.9%.ConclusionThe enlargement of the upper airway after wearing the OA changed its airflow dynamics, which decreased the negative pressure and resistance in narrow areas of the upper airways. Thus, the collapsibility of the upper airways was reduced and patency was sustained.

A Clinical Test to Capture Humidity From Exhalation: Self-Humidification

2019 ◽  
Author(s):  
Sandra Grau-Bartual ◽  
Ahmed M. Al-Jumaily
Keyword(s):  
Lung Diseases ◽  
Positive Airway Pressure ◽  
Water Molecules ◽  
Clinical Test ◽  
Upper Airways ◽  
Non Invasive ◽  
Obstructive Sleep ◽  
Exhaled Air ◽  
Positive Airway Pressure Ventilation ◽  
Very High

Abstract Lung supportive devices are widely used for non-invasive positive airway pressure ventilation and respiratory therapy to help provide breathing support for patients with various lung diseases including Obstructive Sleep Apnea. These devices deliver air to the patient through a facial or nasal mask, and the use of these devices normally results in dryness in the upper airways. However, the exhaled air consists of very high humidity content hence the moisture content of this air can be reused in the inhalation process. This research focuses on testing clinically a previously developed element which can recover the moisture from the exhaled air and use it for re-inhalation. 21 healthy volunteers between the ages of 21 and 55, where 38.1% were females and 61.9% males, were invited to participate in this study. The results show a viable element which is able to trap water molecules from the expiration airflow and release them into the inspiration airflow.

scholarly journals Forced eruption and implant site development in the aesthetic zone: A case report

2014 ◽  
Vol 08 (02) ◽  
pp. 269-275 ◽  
Author(s):  
Huseyin Gencay Keceli ◽  
Mustafa Baris Guncu ◽  
Zeynep Atalay ◽  
Mustafa Serdar Evginer
Keyword(s):  
Case Report ◽  
Multidisciplinary Approach ◽  
Bone Apposition ◽  
Non Invasive ◽  
Site Development ◽  
Invasive Method ◽  
The Aesthetic ◽  
Atraumatic Extraction ◽  
Forced Eruption ◽  
Crown Dimensions

ABSTRACTA multidisciplinary approach to develop the future implant site in the aesthetic zone was illustrated. A patient with perio-endo combined lesion at her upper central incisors was treated. Before extraction, forced eruption was performed and 12 months later, satisfactory amount of bone apposition was detected. At 2 weeks after atraumatic extraction, implants were placed and loaded with implant-supported restorations following osseous healing. Variables related to crown dimensions, periodontal/peri-implanter soft-tissue health and patient's aesthetic satisfaction were recorded at baseline, before extraction and after prosthetic treatment. At 12-month control, crown dimensions in the implant site were identical to the baseline and in addition to the healthy peri-implant tissues, successful aesthetics were obtained. Forced eruption is a successful non-invasive method to develop the aesthetics of the peri-implant tissues and implant-supported restorations.

Mandibular Advancement Device use for therapy of simple snoring: mini review

2021 ◽  
Vol 11 (41) ◽  
pp. 30-33
Author(s):  
Erdem Atalay Cetinkaya
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Mandibular Advancement Device ◽  
Mandibular Advancement ◽  
Treatment Modalities ◽  
Upper Airways ◽  
Obstructive Sleep ◽  
Surgical Methods ◽  
Simple Snoring

AbstractOral devices that treat obstructive sleep apnea are an easy and influential option to protect the upper airways from sleep obstructions. One example is the mandibular advancement device (MAD), which is a non-invasive apparatus specified in adults with simple snoring and mild obstructive sleep apnea. Recently, due to the constraints of other therapies, like positive airway pressure treatment and surgical methods, there has been growing interest in the use of oral appliance for simple snoring patients. MAD is managed to improve the upper airway volume, minimize upper airway collapse and reduce snoring. On the other hand, it remains inferior to CPAP in the reduction of the apnea-hypopnea scores, with therapy success varying from 24% to 72%. The treatment modalities include skilled physicians and multidisciplinary strategies to treat patients with snoring and obstructive sleep apnea (OSA) effectively. Some researchers also suggest potential predictors of progress in care, but specific criteria for patient selection and predictive clinical principles for effectiveness in all treatment modalities are still needed. The aim of this brief clinical Study is to review MAD brief history, design, indications, contraindications, therapy efficiency, side effects, and current perspectives.

scholarly journals Successful treatment of laryngomalacia and bilateral vocal cord paralysis with continuous positive airway pressure

2010 ◽  
Vol 63 (3-4) ◽  
pp. 285-288 ◽  
Author(s):  
Aleksandar Sovtic ◽  
Predrag Minic ◽  
Miodrag Vukcevic ◽  
Milan Rodic
Keyword(s):  
Case Report ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Invasive Ventilation ◽  
Bilateral Vocal Cord Paralysis ◽  
Sleep Study ◽  
Transdiaphragmatic Pressure ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Obstructive Sleep

Introduction Laryngomalacia is the most frequent congenital anomaly of airways, and it may cause obstructive sleep apneas. The associated vocal cord paralysis may aggravate the symptoms of upper airway obstruction. Case report In a 14 month old boy severe laryngomalacia and bilateral vocal cord paralysis were diagnosed by flexible bronchoscopy. A sleep study showed a severe obstructive sleep apnoea (OSA). The patient was ventilated at home via the face mask with non invasive mechanical ventilation (CPAP) for a year. The level of pressure had to be set at 7cm H2O to correct desaturation with an improvement in mean SpO2. On the follow up bronchoscopic examination laryngomalatia was improved, vocal cord paralysis persisted and sleep study revealed significant improvement. Discussion In the patient with severe laryngomalatia and bilateral vocal cord paralysis with OSA conservative treatment with CPAP was used instead of a surgical intervention. Non invasive ventilation was used every night, for at least 6 hours, without adverse events. Invasive measurement of transdiaphragmatic pressure is the best way of titrating of CPAP level. This case report suggests the efficacy of noninvasive titrating of CPAP level by the hemoglobin oxygen saturation trend measurement. Conclusion In case of severe laryngomalatia and associated vocal cord paralysis, followed by OSA non invasive ventilation by nasal CPAP represents an effective and safe alternative to surgery.

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