scholarly journals Osteopathic Manipulation of the Sphenopalatine Ganglia Versus Sham Manipulation, in Obstructive Sleep Apnoea Syndrom: A Randomised Controlled Trial

2021 ◽  
Vol 11 (1) ◽  
pp. 99
Author(s):  
Valérie Attali ◽  
Olivier Jacq ◽  
Karine Martin ◽  
Isabelle Arnulf ◽  
Thomas Similowski
Keyword(s):  
Adverse Events ◽  
Nasal Obstruction ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Upper Airways ◽  
Osteopathic Manipulation ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Randomised Controlled

(1) Background: osteopathic manipulation of the sphenopalatine ganglia (SPG) blocks the action of postganglionic sensory fibres. This neuromodulation can reduce nasal obstruction and enhance upper airway stability. We investigated the manipulation of the SPG in 31 patients with obstructive sleep apnoea syndrome (OSAS); (2) Methods: Randomised, controlled, double-blind, crossover study. Participants received active (AM), then sham manipulation (SM), or vice versa. The primary endpoint was apnoea-hypopnoea index (AHI). Secondary endpoints were variation of nasal obstruction evaluated by peak nasal inspiratory flow (PNIF) and upper airways stability evaluated by awake critical closing pressure [awake Pcrit]), at 30 min and 24 h. Schirmer’s test and pain were assessed immediately post-manipulation. Tactile/gustatory/olfactory/auditory/nociceptive/visual sensations were recorded. Adverse events were collected throughout. (3) Results: SPG manipulation did not reduce AHI (p = 0.670). PNIF increased post-AM but not post-SM at 30 min (AM-SM: 18 [10; 38] L/min, p = 0.0001) and 24 h (23 [10; 30] L/min, p = 0.001). There was no significant difference on awake Pcrit (AM-SM) at 30 min or 24 h). Sensations were more commonly reported post-AM (100% of patients) than post-SM (37%). Few adverse events and no serious adverse events were reported. (4) Conclusions: SPG manipulation is not supported as a treatment for OSAS but reduced nasal obstruction. This effect remains to be confirmed in a larger sample before using this approach to reduce nasal congestion in CPAP-treated patients or in mild OSAS.

scholarly journals The Effect of Change in Posture on Spirometry in Patients with Obstructive Sleep Apnoea Syndrome

2019 ◽  
Vol 19 (4) ◽  
pp. 310
Author(s):  
Redha Al Lawati ◽  
Mohammed A. Al Abri ◽  
Balaji Kuppuswamy ◽  
Amira Al-Kharousi ◽  
Al Yaqdhan Al-Atbi ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
University Hospital ◽  
Health Concern ◽  
Lower Airway ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Obese Patients ◽  
Sleep Apnoea Syndrome ◽  
Obstructive Sleep ◽  
Significant Difference

Objectives: Obstructive sleep apnoea syndrome (OSAS) is a growing health concern as it is associated with serious comorbidities. OSAS is mainly related to obesity, age, gender and a narrowed upper airway is commonly seen in patients with OSAS. This study aimed to compare spirometry parameters between obese OSAS patients and non-obese OSAS patients when patients moved from sitting to supine. Methods: This cross-sectional study was conducted at Sultan Qaboos University Hospital, Muscat, Oman, between December 2009 and December 2010. Patients with severe OSAS and who were OSAS treatment naïve were recruited. Spirometry was performed in all patients in sitting and supine positions to assess forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC, forced expiratory flow (FEF) 50%, FEF 25–75%, maximum forced inspiratory flow and expiratory reserve volume. The mean difference in spirometry parameters between patients in sitting and supine positions was calculated. Results: A total of 27 OSAS patients (19 males and 8 females) were included in this study. There was a significant difference in FEV1/FVC in obese and non-obese patients when changing position (P = 0.03). In addition, there was a significant change between male and female patients’ FVC percentages (P <0.05). Male patients with OSAS had reduced FVC compared to females. There was no significant difference in the remaining spirometry parameters with patients’ change of position. Conclusion: A supine position may cause lower airway obstruction in obese patients with OSAS. The reduced FVC in males possibly contributes to the high prevalence of OSAS in men compared to women.Keywords: Obstructive Sleep Apnea; Obesity; Gender; Spirometry; Posture; Oman.

Investigation of smell and taste function in patients with obstructive sleep apnoea syndrome

2019 ◽  
Vol 133 (05) ◽  
pp. 376-379 ◽  
Author(s):  
A Yenigun ◽  
N Degirmenci ◽  
S S Goktas ◽  
R Dogan ◽  
O Ozturan
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Upper Respiratory Tract ◽  
Taste Test ◽  
Sleep Apnoea Syndrome ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Taste And Smell

AbstractObjectiveThis study investigated the relationship between disease severity and taste and smell functions in patients with obstructive sleep apnoea syndrome.MethodsA total of 65 patients with recurrent upper airway obstruction during sleep were included. Participants were divided into four groups according to apnoea-hypopnoea index, obtained on polysomnography. Smell and taste tests were performed on these patients.ResultsA significant difference was observed between the smell thresholds of the groups for the identification test (p = 0.016). In the taste test, significant differences were observed between the groups in terms of sweet, sour, salty and bitter taste test thresholds (p = 0.029, p = 0.0005, p = 0.001 and p = 0.017, respectively).ConclusionAs sleep apnoea severity increased (according to the apnoea-hypopnoea index) in obstructive sleep apnoea syndrome patients, the taste and smell thresholds decreased due to the effect of neuropathy and inflammation in the upper respiratory tract.

scholarly journals MECHANISMS OF ENDOCRINOLOGY: Mechanisms of disease: the endocrinology of obstructive sleep apnoea

2019 ◽  
Vol 180 (3) ◽  
pp. R91-R125 ◽  
Author(s):  
Aikaterini Lavrentaki ◽  
Asad Ali ◽  
Brendan G Cooper ◽  
Abd A Tahrani
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Negative Impact ◽  
Endocrine System ◽  
Epidemiological Studies ◽  
Sleep Apnoea ◽  
Upper Airways ◽  
Obstructive Sleep ◽  
Bidirectional Relationship ◽  
Randomised Controlled ◽  
The Impact

Obstructive sleep apnoea (OSA) is a common disorder that is associated with serious comorbidities with a negative impact on quality of life, life expectancy and health costs. As OSA is related to obesity and is associated with sleep disruption, increased inflammation and oxidative stress, it is not surprising that OSA has an impact on the secretion of multiple hormones and is implicated in the development of many endocrine conditions. On the other hand, many endocrine conditions that can affect obesity and/or upper airways anatomy and stability have been implicated in the development or worsening of OSA. This bidirectional relationship between OSA and the endocrine system has been increasingly recognised in experimental and epidemiological studies and there are an increasing number of studies examining the effects of OSA treatment on endocrine conditions and vice versa. In this review article, we will critically appraise and describe the impact of OSA on the endocrine system including obesity, dysglycaemia, the pituitary, the thyroid, the adrenals, the reproductive system and the bones. In each section, we will assess whether a bidirectional relationship exists, and we will describe the potential underlying mechanisms. We have focused more on recent studies and randomised controlled trials where available and attempted to provide the information within clinical context and relevance.

scholarly journals Agreement between electronic and paper Epworth Sleepiness Scale responses in obstructive sleep apnoea: secondary analysis of a randomised controlled trial undertaken in a specialised tertiary care clinic

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e019255 ◽  
Author(s):  
Lily Chen ◽  
Julia L Chapman ◽  
Brendon J Yee ◽  
Keith K H Wong ◽  
Ronald R Grunstein ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Obstructive Sleep Apnoea ◽  
Epworth Sleepiness Scale ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Sleep Apnoea ◽  
Care Clinic ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Randomised Controlled

ObjectivesOriginally developed as a paper questionnaire, the electronic Epworth Sleepiness Scale (ESS) is widely used in sleep clinics and sleep population research. Despite potential differences between computer-based and conventional questionnaire delivery, studies have not evaluated the agreement between electronic and paper versions of the ESS. Given the widespread use of the ESS, a bias between results would present considerable data concerns. Thus, the aim of this study was to examine agreement between electronic and paper ESS responses in obstructive sleep apnoea (OSA).DesignWe undertook a secondary analysis of baseline data from a randomised controlled trial (ANZCTR: ACTRN12611000847910).SettingData were collected in a tertiary sleep research laboratory located in Sydney, Australia.ParticipantsData were analysed from 112 adult patients with OSA.MeasurementsPatients were given the English version of the ESS as part of a battery of sleep laboratory questionnaires. They completed electronic and subsequently paper ESS questionnaires on the same day.ResultsWe found no significant difference between electronic and paper ESS questionnaires (mean=0.1, SD=2.1, 95% CI −0.3 to 0.5, P=0.57) or heteroscedasticity. There was no evidence of bias along the range of the measure. 95% limits of agreement at 4.3 and −4.1 were comparable with previous data.ConclusionsWe found no evidence of bias between electronic and paper ESS questionnaires in this sample of patients with OSA, as the two formats displayed sufficient agreement to be clinically comparable. Regardless of severity, patients reported the same level of daytime sleepiness with the same level of accuracy across both measures.Trial registration numberACTRN12611000847910; Pre-results.

scholarly journals Modafinil/armodafinil in obstructive sleep apnoea: a systematic review and meta-analysis

2016 ◽  
Vol 47 (5) ◽  
pp. 1420-1428 ◽  
Author(s):  
Julia L. Chapman ◽  
Andrew Vakulin ◽  
Jan Hedner ◽  
Brendon J. Yee ◽  
Nathaniel S. Marshall
Keyword(s):  
Adverse Events ◽  
Obstructive Sleep Apnoea ◽  
Meta Analysis ◽  
Safety Data ◽  
Sleep Apnoea ◽  
European Medicines Agency ◽  
Controlled Trials ◽  
Serious Adverse Events ◽  
Obstructive Sleep ◽  
Randomised Controlled

Modafinil is used internationally to treat residual sleepiness despite continuous positive airway pressure in obstructive sleep apnoea (res-OSA). In 2011, the European Medicines Agency removed the indication based on an unfavourable risk–benefit profile in two trials for efficacy and all accumulated safety data. We performed a meta-analysis of all randomised controlled trials of modafinil (or armodafinil) in res-OSA to quantify efficacy and safety.We systematically searched and assessed studies from major databases, conferences and trials registries to find randomised, placebo-controlled trials of modafinil/armodafinil for ≥2 weeks in adult res-OSA treating sleepiness.We analysed 10 of the 232 articles identified that met inclusion criteria (1466 patients). Modafinil/armodafinil improved the Epworth Sleepiness Scale score (2.2 points, 95% CI 1.5–2.9) and the Maintenance of Wakefulness Test over placebo (3 min, 95% CI 2.1–3.8 min). Modafinil/armodafinil tripled adverse events and doubled adverse events leading to withdrawal but did not increase serious adverse events (hospitalisations or death).Modafinil and armodafinil improve subjective and objective daytime sleepiness in res-OSA. We believe our analysis is a fairer analysis of the risk–benefit profile of this indication. Clinicians may want to use this data to balance the risks and benefits on a case-by-case basis with their patients.

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