scholarly journals Oral appliances: An odds-on in obstructive sleep apnoea management

2021 ◽  
Vol 7 ◽  
pp. 41-45
Author(s):  
S. R. Apoorva ◽  
Hiremath Shaashi ◽  
Sunantha Selvaraj
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Treatment Modalities ◽  
Surgical Approaches ◽  
Oral Appliances ◽  
Upper Airway Resistance Syndrome ◽  
Neurologic Disorders ◽  
Obstructive Sleep ◽  
Quality Of Living

Breathing affiliated with sleep disorders usually lies between simple snoring without sleepiness, upper airway resistance syndrome, obstructive sleep apnoea (OSA) syndrome, and hypercapnic respiratory failure. Of all these, OSA is very often accompanied with morning symptoms and extension of comorbidities and mortalities with a high prevalence rate. General health implications and an altered quality of living are the major setbacks. Mostly patients with neurologic disorders are affected. There are many surgical and non-surgical approaches concerned with its management. This review article provides a description of oral appliances along with recent treatment modalities, clinical efficacy of alternative treatment modalities of OSA patients.

scholarly journals Intervention to enhance adherence to mandibular advancement appliance in patients with obstructive sleep apnoea: study protocol for a randomised clinical trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Harishri Tallamraju ◽  
J. Tim Newton ◽  
Padhraig S. Fleming ◽  
Ama Johal
Keyword(s):  
Social Support ◽  
Clinical Trial ◽  
Obstructive Sleep Apnoea ◽  
Treatment Success ◽  
Upper Airway ◽  
Randomised Clinical Trial ◽  
Sleep Apnoea ◽  
Mandibular Advancement ◽  
Treatment Modalities ◽  
Obstructive Sleep

Abstract Background Obstructive sleep apnoea (OSA) is a sleep-related breathing disorder characterised by the repeated episodic collapse of the upper airway during sleep, resulting in sleep deprivation, giving rise to apnoeas and hypopnoeas. Based on the severity of OSA, there are two primary treatment modalities, continuous positive airway pressure (CPAP) and mandibular advancement appliances (MAA); both are adherence-dependent. MAA is offered to those with mild to moderate OSA and is prescribed as an alternative to patients intolerable to CPAP. However, adherence to MAA treatment is variable and declines over time. Hence, the current study aims to assess the effectiveness of the stage-matched intervention, the Health Action Process Approach (HAPA), on adherence to MAA in patients with OSA. Methods A single-centre randomised clinical trial will be undertaken at Bart’s Health NHS Trust. Fifty-six participants with newly diagnosed OSA are planned to be enrolled in the study and randomised to intervention care (IC) and standardised care (SC) groups. Participants in the SC group will receive routine care whilst participants in the IC group will receive the stage-matched intervention, developed using the HAPA model. Data indicating MAA adherence will be collected both objectively and subjectively, from micro-sensors embedded in the MAA design and sleep diaries, respectively at 3, 6, 18 and 36 months. In addition, a range of questionnaires designed to assess risk perception, outcome expectancy, and self-efficacy (SEMSA) and quality of sleep (PSQI and ESS) and life (EQ-5DL), socio-economic and social support scales will be used. Discussion The currently available treatments for obstructive sleep apnoea depend entirely on the patient’s acceptance and use. There are several factors that affect cooperation and wear for example patients’ awareness of their condition, social support and psychological behaviour. In addition, mood, such as anxiety, stress, and depression, may affect wear. At the same time, we know that interventions involving more education and behaviour approaches can help patients adapt more easily to some treatments. As a result, the present trial aims to explore the potential role of these factors to maximise treatment success and minimise side effects. Trial registration ClinicalTrials.gov NCT04092660. Registered on September 6, 2019

Upper airway volumetric changes of obstructive sleep apnoea patients treated with oral appliances: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Vasileios K Dontsos ◽  
Athina Chatzigianni ◽  
Moschos A Papadopoulos ◽  
Evangelia Nena ◽  
Paschalis Steiropoulos
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnoea ◽  
Meta Analysis ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Cochrane Library ◽  
Apnea Hypopnea Index ◽  
Oral Appliances ◽  
Volume Increase ◽  
Obstructive Sleep

Summary Background Obstructive sleep apnoea (OSA) is a common sleep-related breathing disorder, attributed to the collapse of the pharyngeal walls and the subsequent complete or partial upper airway obstruction. Among different treatment options for OSA, Continuous Positive Airway Pressure, and oral appliances (OAs) have been used, with various outcomes and side effects. Objective The aim of this study was to summarize current knowledge in an evidence-based manner regarding the upper airway volume increase of OSA patients while treated with OAs. Search methods Electronic search was conducted in Pubmed, Cochrane Library, and Scopus, up to May 2020. Selection criteria Studies were selected after the application of predetermined eligibility criteria. Data collection and analysis Mean airway volume differences and the corresponding 95% confidence intervals were calculated, using the random effects model. Sensitivity, exploratory, and meta-regression analyses were also implemented. Results Eleven studies filled the inclusion criteria and were included in the systematic review, while 10 of them were suitable for meta-analysis. In total, 291 patients were included, with mean upper airway volume increase of 1.95 cm3 (95% CI, 1.37–2.53; P < 0.001) with Mandibular Advancement Devices in place. In all studies, post-treatment Apnea Hypopnea Index (AHI) was either <10 events/hour or was reduced by more than 50% from baseline levels. A greater increase of the velopharynx volume was observed, regarding airway compartments. Conclusions Treatment with OAs in OSA may lead to a significant increase of the upper airway volume with a subsequent decrease of AHI. The velopharynx seems to be affected the most from OA therapy.

scholarly journals Obstructive Sleep Apnoea Syndrome and Weight Loss: Review

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Douglas C. Cowan ◽  
Eric Livingston
Keyword(s):  
Weight Loss ◽  
Obstructive Sleep Apnoea ◽  
Dietary Intervention ◽  
Therapeutic Option ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Surgical Approaches ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Central Adiposity ◽  
Obstructive Sleep

Obstructive sleep apnoea (OSA) syndrome is common, and obesity is a major risk factor. Increased peripharyngeal and central adiposity result in increased pharyngeal collapsibility, through increased mechanical loading around the upper airway, reduced tracheal traction on the pharynx, and reduced neuromuscular activity, particularly during sleep. Significant and sustained weight loss, if achieved, is likely to be a useful therapeutic option in the management of OSA and may be attempted by behavioural, pharmacological, and surgical approaches. Behavioural therapy programs that focus on aspects such as dietary intervention, exercise prescription patients and general lifestyle counselling have been tested. Bariatric surgery is an option in the severely obese when nonsurgical measures have failed, and laparoscopic adjustable gastric banding and Roux-en-Y gastric bypass are the most commonly employed techniques in the United Kingdom. Most evidence for efficacy of surgery comes from cohort studies. The role of sibutramine in OSA in the obese patients has been investigated, however, there are concerns regarding associated cardiovascular risk. In this paper the links between obesity and OSA are discussed, and the recent studies evaluating the behavioural, pharmacological and surgical approaches to weight loss in OSA are reviewed.

scholarly journals Role of Paediatric Dentist in Non-Invasive Management of Obstructive Sleep Apnoea in Children

2021 ◽  
Vol 10 (17) ◽  
pp. 1251-1256
Author(s):  
Megha Sethi ◽  
Shveta Sood ◽  
Naresh Sharma ◽  
Akshara Singh
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Attractive Alternative ◽  
Oral Appliances ◽  
Non Invasive ◽  
Obstructive Sleep ◽  
Paediatric Dentist ◽  
Invasive Management

BACKGROUND Obstructive sleep apnoea (OSA) is a chronic disorder in which repetitive episodes of cessation of breathing occurs during sleep due to collapse of upper airway leading to recurrent awakening, sleep fragmentation, and perturbation in ventilatory function. The disorder is much more common than realised and the manifestations in children are different from those in adults. OSAS may present in different ways like cognitive dysfunction, excessive day time somnolence, decreased attention span, drooling of saliva, mood disorders like depression or irritability as well as adverse cardiovascular sequelae like hypertension, heart failure. Polysomnography or overnight sleep studies remain the gold standard for the diagnosis of paediatric obstructive sleep apnoea (POSA) disorder. Therapeutic approaches for POSA include surgical and nonsurgical means. The choice of therapy depends on various factors like aetiology, severity of the POSA and patient’s choice. Although continuous positive airway pressure (CPAP) remains the first line therapy in adults, the introduction of oral appliances provided an attractive alternative and made the role of dentists more prominent in management of this disorder. OSA is often under-diagnosed due to lack of awareness. So, it is essential for dentists to be aware of the various aspects of this disorder as well as its management. KEY WORDS OSA, Paediatric Dentist, Oral Appliances, Non-Invasive Management

Volume-pressure properties of the upper airway in normal subjects and patients with obstructive sleep apnoea

Respirology ◽  
1999 ◽  
Vol 4 (1) ◽  
pp. 69-75 ◽  
Author(s):  
Denan Wu ◽  
Wataru Hida ◽  
Yoshihiro Kikuchi ◽  
Shinichi Okabe ◽  
Hajime Kurosawa ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Upper Airway ◽  
Normal Subjects ◽  
Sleep Apnoea ◽  
Obstructive Sleep
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