scholarly journals Muscular Assessment in Patients With Severe Obstructive Sleep Apnea Syndrome: Protocol for a Case-Control Study (Preprint)

2021 ◽  
Author(s):  
Paz Francisca Borrmann ◽  
Carlos O'Connor-Reina ◽  
Jose M Ignacio ◽  
Elisa Rodriguez Ruiz ◽  
Laura Rodriguez Alcala ◽  
...  

BACKGROUND Myofunctional therapy is currently a reasonable therapeutic option to treat obstructive sleep apnea-hypopnea syndrome (OSAHS). This therapy is based on performing regular exercises of the upper airway muscles to increase their tone and prevent their collapse. Over the past decade, there has been an increasing number of publications in this area; however, to our knowledge, there are no studies focused on patients who can most benefit from this therapy. OBJECTIVE This protocol describes a case-control clinical trial aimed at determining the muscular features of patients recently diagnosed with severe OSAHS compared with those of healthy controls. METHODS Patients meeting set criteria will be sequentially enrolled up to a sample size of 40. Twenty patients who meet the inclusion criteria for controls will also be evaluated. Patients will be examined by a qualified phonoaudiologist who will take biometric measurements and administer the Expanded Protocol of Orofacial Myofunctional Evaluation with Scores (OMES), Friedman Staging System, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index questionnaires. Measures of upper airway muscle tone will also be performed using the Iowa Oral Performance Instrument and tongue digital spoon devices. Evaluation will be recorded and reevaluated by a second specialist to determine concordance between observers. RESULTS A total of 60 patients will be enrolled. Both the group with severe OSAHS (40 patients) and the control group (20 subjects) will be assessed for differences between upper airway muscle tone and OMES questionnaire responses. CONCLUSIONS This study will help to determine muscle patterns in patients with severe OSAHS and can be used to fill the gap currently present in the assessment of patients suitable to be treated with myofunctional therapy. CLINICALTRIAL ISRCTN Registry ISRCTN12596010; https://www.isrctn.com/ISRCTN12596010 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/30500

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 323
Author(s):  
Venkata Koka ◽  
Andrea De Vito ◽  
Gabriel Roisman ◽  
Michel Petitjean ◽  
Giulio Romano Filograna Pignatelli ◽  
...  

Obstructive sleep apnea (OSA) syndrome is a multi-factorial disorder. Recently identified pathophysiological contributing factors include airway collapsibility, poor pharyngeal muscle responsiveness, a low arousal threshold, and a high loop gain. Understanding the pathophysiology is of pivotal importance to select the most effective treatment option. It is well documented that conventional treatments (continuous positive airway pressure (CPAP), upper airway surgery, and dental appliance) may not always be successful in the presence of non-anatomical traits, especially in mild to moderate OSA. Orofacial myofunctional therapy (OMT) consists of isotonic and isometric exercises targeted to oral and oropharyngeal structures, with the aim of increasing muscle tone, endurance, and coordinated movements of pharyngeal and peripharyngeal muscles. Recent studies have demonstrated the efficacy of OMT in reducing snoring, apnea–hypopnea index, and daytime sleepiness, and improving oxygen saturations and sleep quality. Myofunctional therapy helps to reposition the tongue, improve nasal breathing, and increase muscle tone in pediatric and adult OSA patients. Studies have shown that OMT prevents residual OSA in children after adenotonsillectomy and helps adherence in CPAP-treated OSA patients. Randomized multi-institutional studies will be necessary in the future to determine the effectiveness of OMT in a single or combined modality targeted approach in the treatment of OSA. In this narrative review, we present up-to-date literature data, focusing on the role of OSA pathophysiology concepts concerning pharyngeal anatomical collapsibility and muscle responsiveness, underlying the response to OMT in OSA patients.


2021 ◽  
pp. 112067212110065
Author(s):  
Murat Serkan Songur ◽  
Yavuz Selim İntepe ◽  
Seray Aslan Bayhan ◽  
Hasan Ali Bayhan ◽  
Ender Şahin ◽  
...  

Purpose: In the present study we evaluate the corneal endothelium using specular microscopy in patients with obstructive sleep apnea syndrome (OSAS). Methods: The study included a total of 100 patients including 35 patients with mild OSAS, 34 patients with moderate OSAS and 31 patients with severe OSAS, and the right eyes of 30 patients as a control group. Patients were examined to exclude the possibility of ocular diseases. Cellular density in the cornea epithelium (cell/mm2), corneal thickness (µ), percentage of hexagonal cells (%) and the coefficient of variation were evaluated using a specular microscope. Results: Corneal thickness was significantly decreased in all OSAS groups when compared to the control group ( p = 0.002), while no significant difference was identified among the OSAS groups. The corneal endothelial cell density, percentage of hexagonal cells and coefficient of variation were significantly different between the OSAS groups and the control group ( p < 0.001). Conclusion: More significant impairments were noted in the corneal endothelium of the patients in the OSAS group than in the control group, and specular microscopy is in valuable in the follow-up and treatment of such patients.


SLEEP ◽  
2009 ◽  
Vol 32 (9) ◽  
pp. 1173-1181 ◽  
Author(s):  
Jingtao Huang ◽  
Laurie R. Karamessinis ◽  
Michelle E. Pepe ◽  
Stephen M. Glinka ◽  
John M. Samuel ◽  
...  

SLEEP ◽  
2019 ◽  
Vol 42 (Supplement_1) ◽  
pp. A287-A287
Author(s):  
Humberto C Sasieta ◽  
Venkata V Dalai ◽  
Farooq Z Cheema ◽  
Ruckshanda Majid ◽  
Reeba Mathew ◽  
...  

2018 ◽  
Vol 21 (1) ◽  
pp. 64
Author(s):  
Marcos Marques Rodrigues ◽  
Lucas Borin Moura ◽  
Ariane De Souza Oliveira ◽  
Marisa Aparecida Cabrini Gabrielli ◽  
Valfrido Antonio Pereira Filho ◽  
...  

<p><strong>Objective</strong>: Obstructive Sleep Apnea (OSA) occurs by recurrent collapse of the upper airway during sleep. It results in complete (apnea) or partial (hypopnea) reduction of airflow and has intimate relation with the upper airway anatomy. Cephalometric analysis has been used to quantify airway dimensions. The aim of this study is evaluate the correlation between the anteroposterior dimension of the upper airway and the severity of obstructive sleep apnea. <strong>Material and Methods</strong>: A retrospective analysis was performed reviewing polysomnographic data (AHI) and anteroposterior cephalometric measurements of pharynx subregions: nasopharynx, oropharynx, hypopharynx. <strong>Results</strong>: The sample consisted of 30 patients. The mean body mass index was 29.60 kg/m<sup>2</sup> and the average age was 46.8 years. Nine patients presented severe OSA, seven had moderate OSA , seven had mild OSA, and seven were healthy.  The Pearson's correlation index between the anteroposterior dimension of the nasopharynx, oropharynx and hypopharynx and AHI was respectively -0.128 (p=0.517), -0.272 (p=0.162) and -0.129 (p=0.513).<strong> Conclusion: </strong>The correlation between anteroposterior linear dimension of the airway and OSA severity, assessed by AHI, was not positive. As an isolated parameter it did not correlate to the severity of the obstrucive sleep apnea syndrome and should be evaluated in conjunction with other factors.</p><p><strong> </strong></p><p><strong>Keywords</strong></p><p>Upper Airway; Obstructive sleep apnea; Cone beam CT.</p>


SLEEP ◽  
2010 ◽  
Vol 33 (7) ◽  
pp. 968-972 ◽  
Author(s):  
Ignacio E. Tapia ◽  
Preetam Bandla ◽  
Joel Traylor ◽  
Laurie Karamessinis ◽  
Jingtao Huang ◽  
...  

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