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Oral Appliance for Sleep Apnea

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https://www.readbyqxmd.com/read/29688857/less-invasive-treatment-of-sleep-disordered-breathing-in-children-with-syndromic-craniosynostosis
#1
Silvia Müller-Hagedorn, Cornelia Wiechers, Jörg Arand, Wolfgang Buchenau, Margit Bacher, Michael Krimmel, Siegmar Reinert, Christian F Poets
BACKGROUND: Infants and children with syndromic craniosynostosis (SCS), such as Apert-, Crouzon- or Pfeiffer syndrome, are prone to sleep disordered breathing (SDB) including obstructive sleep apnea and upper airway resistance syndrome (OSAS, UARS), potentially leading to tracheostomy. We modified the Tübingen Palatal Plate (TPP), an oral appliance with a velar extension effectively treating airway obstruction in Robin sequence, by attaching a tube to its velar extension to bridge the narrow pharyngeal airway in SCS patients...
April 23, 2018: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/29667512/alternative-technique-to-transfer-jaw-relations-for-custom-mandibular-advancement-devices-a-case-report
#2
Filiz Keyf, Defne Burduroğlu, Selma Fırat Güven, Bülent Çiftçi
Background Oral appliance therapy for obstructive sleep apnea can be helpful in mild and moderate cases. This clinical report evaluates the efficacy of a protocol that predicts an optimal jaw position and describes the response of a young OSA patient to treatment. Clinical Presentation A 27-year-old woman was diagnosed with moderate OSA and had an apnea-hypopnea index (AHI) of 25.8/hr. In order to fabricate a custom device, an alternative procedure to determine the optimal protrusion and vertical positioning of the jaw was applied...
April 18, 2018: Cranio: the Journal of Craniomandibular Practice
https://www.readbyqxmd.com/read/29642990/oral-interventions-for-obstructive-sleep-apnea
#3
Vasiliki Koretsi, Theodore Eliades, Spyridon N Papageorgiou
BACKGROUND: The effectiveness of intraoral appliances (IOA), maxillary expansion (ME), and maxillomandibular advancement (MMA) in the treatment of children and adults with obstructive sleep apnea (OSA) has not yet been adequately assessed. METHODS: An umbrella review was performed based on established guidelines for evidence-based medicine. Data synthesis was performed only from randomized controlled trials with Paule-Mandel random-effects meta-analyses / meta-regressions using mean differences (MDs) and 95% confidence intervals (CIs) and was followed by the qualitative evaluation of the meta-evidence...
March 23, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29628335/dental-and-skeletal-changes-associated-with-long-term-oral-appliance-use-for-obstructive-sleep-apnea-a-systematic-review-and-meta-analysis
#4
REVIEW
Takafumi Araie, Kentaro Okuno, Hitomi Ono Minagi, Takayoshi Sakai
An oral appliance (OA) is an effective treatment option for patients with obstructive sleep apnea (OSA), but dental and skeletal changes have been detected by many studies after long-term OA use. Better understanding of the long-term side effects may decrease discontinuation of OA use and assist clinicians to make informed decisions. Accordingly, a systematic review and meta-analysis were performed to evaluate the dental and skeletal changes associated with OAs designed to advance the mandible. The quality of the studies was determined by using the risk of bias assessment tool for non-randomized studies (RoBANS), and 12 studies were included in the meta-analysis...
March 1, 2018: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/29524091/towards-a-prediction-model-for-drug-induced-sleep-endoscopy-as-selection-tool-for-oral-appliance-treatment-and-positional-therapy-in-obstructive-sleep-apnea
#5
P E Vonk, A M E H Beelen, N de Vries
PURPOSE: To evaluate the effect of different passive maneuvers on upper airway patency during drug-induced sleep endoscopy (DISE) compared to recent literature on treatment outcomes of positional therapy (PT), oral appliance therapy (OAT), and combined treatment in obstructive sleep apnea (OSA) patients. METHODS: A retrospective, single-center cohort study including a consecutive series of 200 OSA patients. All patients underwent DISE with and without manually performed jaw thrust and lateral head rotation by using the VOTE classification...
March 9, 2018: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29520669/the-use-of-oral-appliances-in-obstructive-sleep-apnea-a-retrospective-cohort-study-spanning-14-years-of-private-practice-experience
#6
Sylvan S Mintz, Reka Kovacs
PURPOSE: In 2005, the American Academy of Sleep Medicine stated, "Oral appliances are indicated for use in patients with mild to moderate obstructive sleep apnea (OSA) who prefer them to CPAP therapy, or who do not respond to, are not appropriate candidates for, or who fail treatment attempts with CPAP." However, this recommendation is based upon variable results from only six studies with more than 100 participants. These studies have assessed the effectiveness of mandibular advancement devices (MADs) in specific groups (military populations, academic institutions, or hospital settings) with no large study conducted in a fee-for-service private practice where the majority of patients receive MADs for OSA...
May 2018: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29506916/prevalence-of-primary-open-angle-glaucoma-among-patients-with-obstructive-sleep-apnea
#7
Arthur H Friedlander, Lindsay L Graves, Tina I Chang, K Karl Kawakami, Urie K Lee, Shannon C Grabich, Zhuang T Fang, Michelle R Zeidler, JoAnn A Giaconi
OBJECTIVE: Our objective was to determine primary open-angle glaucoma (POAG) prevalence among obstructive sleep apnea (OSA) patients because the perioperative environment risks further damaging the optic nerve. STUDY DESIGN: We analyzed a "convenience sample" referred by Sleep Medicine for oral appliances because of continuous positive airway pressure intolerance. We determined the aggregate prevalence of the 3 POAG subtypes-"classic" open-angle glaucoma (COAG), normal-tension glaucoma (NTG), and open-angle glaucoma suspect (OAGS)-among the index population and compared it with that of same hospital's general population...
January 31, 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/29480361/effect-of-long-term-oral-appliance-therapy-on-obstruction-pattern-in-patients-with-obstructive-sleep-apnea
#8
Seo Yun Jo, Sung Min Lee, Kang Hyun Lee, Dong-Kyu Kim
PURPOSE: Oral appliance therapy is an alternative treatment modality for obstructive sleep apnea (OSA). However, there have been no studies to determine whether changes in the obstructive pattern occur following long-term use of oral devices. Therefore, we examined whether the obstructive pattern changes in patients with OSA who undergo long-term oral appliance therapy using drug-induced sleep endoscopy (DISE). METHODS: We investigated 156 consecutive patients diagnosed with OSA...
May 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29277633/which-place-of-pharmacological-approaches-beyond-continuous-positive-airway-pressure-to-treat-vascular-disease-related-to-obstructive-sleep-apnea
#9
REVIEW
Elodie Gautier-Veyret, Jean-Louis Pépin, Françoise Stanke-Labesque
Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial or complete upper airway obstruction, occurring during sleep, leading to chronic intermittent hypoxia (IH), which harms the cardiovascular system. OSA is associated with both functional and structural vascular alterations that contribute to an increased prevalence of fatal and non-fatal cardiovascular events. OSA is a heterogeneous disease with respect to the severity of hypoxia, the presence of daytime symptoms, obesity, and cardiovascular comorbidities...
December 23, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29274155/oral-appliance-therapy-in-obstructive-sleep-apnea-long-term-adherence-and-patients-experiences
#10
B Saglam-Aydinatay, T Taner
BACKGROUND: Despite the advances in the treatment of obstructive sleep apnea (OSA) with mandibular advancement appliances (MAA), their effectiveness is dependent on the patients compliance. Our aims were to evaluate the long-term adherence to MAA therapy and patients experiences of the treatment in OSA. MATERIAL AND METHODS: Sixty-nine patients (52 males, 17 females; Mean age: 54.4±10.8 years) were included in the study. The subjects were mild (56%) and moderate (44%) OSA patients who had been treated using MAA at least 4 years prior to the study...
January 1, 2018: Medicina Oral, Patología Oral y Cirugía Bucal
https://www.readbyqxmd.com/read/29247295/the-predictive-value-of-drug-induced-sleep-endoscopy-for-cpap-titration-in-osa-patients
#11
Ming-Chin Lan, Yen-Bin Hsu, Ming-Ying Lan, Yun-Chen Huang, Ming-Chang Kao, Tung-Tsun Huang, Tsan-Jen Chiu, Mei-Chen Yang
PURPOSE: The aim of this study was to identify possible upper airway obstructions causing a higher continuous positive airway pressure (CPAP) titration level, utilizing drug-induced sleep endoscopy (DISE). METHODS: A total of 76 patients with obstructive sleep apnea (OSA) underwent CPAP titration and DISE. DISE findings were recorded using the VOTE classification system. Polysomnographic (PSG) data, anthropometric variables, and patterns of airway collapse during DISE were analyzed with CPAP titration levels...
December 15, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29204583/osa-treatment-history-in-an-upper-airway-stimulation-trial-cohort
#12
Ryan J Soose, Tapan A Padhya, M Boyd Gillespie, Oleg Froymovich, Ho-Sheng Lin, B Tucker Woodson
Objectives: Analyze the obstructive sleep apnea (OSA) treatment history in a group of participants who enrolled in a hypoglossal nerve stimulation trial. Methods: Moderate-severe OSA patients with difficulty adhering to CPAP presented for enrollment in a multicenter trial. Self-reported history on prior OSA medical therapy was collected at enrollment, including OSA diagnosis date, CPAP start and stop dates, oral appliance trial, and reasons for discontinuation or non-adherence...
June 2017: World journal of otorhinolaryngology—head and neck surgery
https://www.readbyqxmd.com/read/29198303/predictors-of-side-effects-with-long-term-oral-appliance-therapy-for-obstructive-sleep-apnea
#13
Hitomi Ono Minagi, Kentaro Okuno, Kanji Nohara, Takayoshi Sakai
STUDY OBJECTIVES: The aim of this study was to investigate the predictors of dental changes associated with long-term treatment with oral appliances (OAs) in patients with obstructive sleep apnea (OSA). METHODS: This was a retrospective study to investigate Japanese patients with OSA receiving long-term treatment with OAs. Comparisons of cephalometric analysis were carried out between the initial and follow-up assessments of dental and skeletal changes. Based on dental changes, predictors that may cause side effects were investigated...
January 15, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29195726/cardiovascular-effects-of-oral-appliance-therapy-in-obstructive-sleep-apnea-a-systematic-review-and-meta-analysis
#14
REVIEW
Grietje E de Vries, Peter J Wijkstra, Ewout J Houwerzijl, Huib A M Kerstjens, Aarnoud Hoekema
Obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality. This study systematically reviews the effects of oral appliance therapy (OAT) on a broad spectrum of cardiovascular outcomes. A literature search was performed up to December 31st 2016. Twenty-five relevant full-text articles were retrieved. Sixteen articles were considered methodologically sufficient, including 11 randomized controlled trials. Pooled data of the RCTs showed significant reductions in daytime systolic and diastolic blood pressure compared to baseline, but no significant reductions in heart rate, except for daytime heart rate when compared to inactive/placebo OAT...
October 26, 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/29152745/impact-of-an-oral-appliance-on-obstructive-sleep-apnea-severity-quality-of-life-and-biomarkers
#15
Enrique Fernández-Julián, Tomás Pérez-Carbonell, Rocío Marco, Verónica Pellicer, Enrique Rodriguez-Borja, Jaime Marco
OBJECTIVE/HYPOTHESIS: To investigate outcomes including efficacy, quality of life, and levels of inflammatory markers of a mandibular advancement device (MAD) for moderate-to-severe obstructive sleep apnea (OSA). STUDY DESIGN: Case-control study. METHODS: Patients with apnea-hypopnea index (AHI) ≥ 15/hr who only accepted MAD therapy (study group) or who refused any treatment (control group) were recruited. At baseline and at 6 months, polysomnography, Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), C-reactive protein (CRP), interleukin 1β, interleukin 6, and tumor necrosis factor α (TNF-α) were assessed in both groups...
November 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29129030/effects-of-cpap-and-mandibular-advancement-device-treatment-in-obstructive-sleep-apnea-patients-a-systematic-review-and-meta-analysis
#16
REVIEW
Martha Schwartz, Luis Acosta, Yuan-Lung Hung, Mariela Padilla, Reyes Enciso
The purpose of this review is to conduct a systematic review and meta-analysis comparing the effects of continuous positive airway pressure (CPAP) with a mandibular advancement device (MAD) in improving the quality of life (sleepiness, cognitive, and functional outcomes) in patients diagnosed with obstructive sleep apnea (OSA). Authors identified randomized, placebo-controlled studies from MEDLINE through PubMed, Web of Science, and the Cochrane Library. Studies were assessed for inclusion and exclusion criteria, as well as risk of bias...
November 11, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29115191/risk-factors-for-the-efficacy-of-oral-appliance-for-treating-obstructive-sleep-apnea-a-preliminary-study
#17
Geun-Shin Lee, Hye-Kyoung Kim, Mee-Eun Kim
Objective To identify potential risk factors of response to oral appliance in patients with obstructive sleep apnea (OSA). Methods Fifteen OSA patients were enrolled. Clinical characteristics, cephalometric measurements, and the results of home sleep testing were retrospectively obtained at baseline, and a sleep test was done again at the end of treatment. Results Twelve subjects were responders and three were non-responders. The diastolic blood pressure, minimum pulse rate, SNA (Angle between sella-nasion and nasion-A point), ANB (Anteroposterior maxilla/mandible discrepancy), and facial convexity of non-responders was higher than those of responders...
November 8, 2017: Cranio: the Journal of Craniomandibular Practice
https://www.readbyqxmd.com/read/29090478/reliability-of-an-adherence-monitoring-sensor-embedded-in-an-oral-appliance-used-for-treatment-of-obstructive-sleep-apnoea
#18
K Gjerde, S Lehmann, I F Naterstad, M E Berge, A Johansson
The aim of this study was to test whether digitally registered use of a mandibular advancement device (MAD) by a built-in thermal sensor was reliable compared to a self-reported diary of MAD use. Eighty consecutive patients referred to a specialist outpatient sleep medicine clinic (HUS) were recruited. Patients of both genders, aged from 25 to 70 years with a diagnosis of mild, moderate or severe, were included. All participants signed a written informed consent when they received the MAD. For the purpose of this reliability study, we found it sufficient to include the first 30 nights of MAD use in the reliability analysis...
February 2018: Journal of Oral Rehabilitation
https://www.readbyqxmd.com/read/29067558/oral-appliance-treatment-outcome-can-be-predicted-by-continuous-positive-airway-pressure-in-moderate-to-severe-obstructive-sleep-apnea
#19
Anders Storesund, Anders Johansson, Bjørn Bjorvatn, Sverre Lehmann
BACKGROUND: Studies show that the therapeutic CPAP pressure is associated with oral appliance (OA) treatment outcome in obstructive sleep apnea (OSA) patients. However, these studies included either CPAP adherent patients using fixed pressure devices, or partly CPAP non-adherent patients using fixed pressure or auto-adjusting (auto-CPAP) devices. In many countries, auto-CPAP is predominately used, and only those non-adherent to therapy need a change to OA. Therefore, studies examining the relationship between CPAP pressures and OA treatment outcome should focus on patients non-adherent to auto-CPAP...
October 24, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29060174/characterization-of-a-tooth-microphone-coupled-to-an-oral-appliance-device-a-new-system-for-monitoring-osa-patients
#20
Yolanda Castillo, Dolores Blanco-Almazan, James Whitney, Barry Mersky, Raimon Jane
Obstructive sleep apnea (OSA) is a highly prevalent chronic disease, especially in elderly and obese populations. Despite constituting a serious health, social and economic problem, most patients remain undiagnosed and untreated due to limitations in current equipment. In this work, we propose a novel method to diagnose OSA and monitor therapy adherence and effectiveness at home in a non-invasive and inexpensive way: combining acoustic analysis of breathing and snoring sounds with oral appliance therapy (OA)...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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