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Oral Appliance for Sleep Apnea

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https://www.readbyqxmd.com/read/28738374/multilevel-obstructive-sleep-apnea-surgery
#1
Hsin-Ching Lin, Edward M Weaver, Ho-Sheng Lin, Michael Friedman
Continuous positive airway pressure (CPAP) is the primary treatment of obstructive sleep apnea/hypopnea syndrome (OSA). Most sleep physicians are in agreement that a certain number of OSA patients cannot or will not use CPAP. Although other conservative therapies, such as oral appliance, sleep hygiene, and sleep positioning, may help some of these patients, there are many who fail all conservative treatments. As sleep surgeons, we have the responsibility to screen patients for both symptoms and signs of OSA...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738372/advances-in-oral-appliances-for-obstructive-sleep-apnea
#2
Ofer Jacobowitz
Oral appliances that advance the mandible are widely used as alternatives to positive airway pressure (PAP) devices or as primary therapy for obstructive sleep apnea (OSA) in adults. Although PAP is more efficacious at lowering the polysomnographic indices of OSA, the clinical effectiveness of PAP and oral appliances is similar, and patients are more likely to adhere to oral appliance therapy than to PAP treatment. Clinical examination is used to determine the candidacy of oral appliances and to select a particular appliance for a given patient...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28734941/sleep-chronic-pain-and-opioid-risk-for-apnea
#3
REVIEW
Serguei Marshansky, Pierre Mayer, Dorrie Rizzo, Marc Baltzan, Ronald Denis, Gilles J Lavigne
Pain is an unwelcome sleep partner. Pain tends to erode sleep quality and alter the sleep restorative process in vulnerable patients. It can contribute to next-day sleepiness and fatigue, affecting cognitive function. Chronic pain and the use of opioid medications can also complicate the management of sleep disorders such as insomnia (difficulty falling and/or staying asleep) and sleep-disordered breathing (sleep apnea). Sleep problems can be related to various types of pain, including sleep headache (hypnic headache, cluster headache, migraine) and morning headache (transient tension type secondary to sleep apnea or to sleep bruxism or tooth grinding) as well as periodic limb movements (leg and arm dysesthesia with pain)...
July 19, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28714534/adjustable-thermoplastic-oral-appliance-versus-positive-airway-pressure-for-obstructive-sleep-apnea
#4
Wish Banhiran, Paraya Assanasen, Cherdchai Nopmaneejumrudlers, Nongyoaw Nujchanart, Wimontip Srechareon, Cheerasook Chongkolwatana, Choakchai Metheetrairut
OBJECTIVES/HYPOTHESIS: To compare outcomes of continuous positive airway pressure (CPAP) and the adjustable thermoplastic mandibular advancement splint (AT-MAS) for obstructive sleep apnea treatment. STUDY DESIGN: Randomized crossover, noninferiority, tertiary center setting. METHODS: Fifty patients with a mean age of 49.5 ± 10.6 years were enrolled. Inclusion criteria were age ≥18 years, apnea-hypopnea index (AHI) ≥5 events/hour, and oxygen saturation ≥70%...
July 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28702829/severe-obstructive-sleep-apnea-treatment-with-oral-appliance-the-impact-on-obstructive-central-and-mixed-events
#5
Maria de Lourdes Rabelo Guimarães, Ana Paula Hermont, Pedro Guimarães de Azevedo, Poliana Lima Bastos, Millena Teles Portela de Oliveira, Iracema Matos de Melo, Guilherme Salles Ottoboni, Gabriela Vedolin, Jorge Machado Caram
PURPOSE: The aim of this study is to evaluate the effectiveness of two types of oral appliance (OA) in the treatment of severe obstructive sleep apnea syndrome (OSAS) and their impact on the reduction of obstructive, central and mixed apneas. METHODS: Forty-eight patients suffering from severe OSAS with a history of non-adherence to positive airway pressure therapy were treated with OA (lingual orthosis and combined orthosis). Polysomnography exams were performed before and after treatment...
July 12, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28701992/verifying-the-relative-efficacy-between-continuous-positive-airway-pressure-therapy-and-its-alternatives-for-obstructive-sleep-apnea-a-network-meta-analysis
#6
Tingwei Liu, Wenyang Li, Hui Zhou, Zanfeng Wang
Obstructive sleep apnea (OSA) is a common breathing disorder, and continuous positive airway pressure (CPAP) therapy together with its alternatives has been developed to treat this disease. This network meta-analysis (NMA) was aimed to compare the efficacy of treatments for OSA. Cochrane Library, MEDLINE, and Embase were searched for eligible studies. A conventional and NMA was carried out to compare all therapies. Sleeping characteristics, including Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), arterial oxygen saturation, and arousal index (AI), and changes of blood pressure were selected as outcomes...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28697968/update-on-pathophysiology-and-treatment-of-childhood-obstructive-sleep-apnea-syndrome
#7
REVIEW
Justin C Brockbank
Obstructive sleep apnea syndrome (OSAS) is common in childhood and is characterized by recurrent upper airway obstructive events during sleep that produce significant neurocognitive and cardiovascular sequelae. The pathophysiology of childhood OSAS is complex and involves mechanical airway obstruction often secondary to adenotonsillar hypertrophy. However, neuromotor abnormalities and instability of central ventilatory control are also implicated. Several surgical and non-surgical treatment options for childhood OSAS are available, and will be discussed...
June 12, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28695399/the-long-term-effects-of-mandibular-advancement-splint-on-cardiovascular-fitness-and-psychomotor-performance-in-patients-with-mild-to-moderate-obstructive-sleep-apnea-a-prospective-study
#8
Ashutosh Gupta, Arvind Tripathi, Piyush Sharma
BACKGROUND: Obstructive sleep apnea (OSA) manifests as a reduction or complete cessation of airflow despite an ongoing inspiratory effort, leading to hypoxemia and hypercapnia. The inability to maintain normal breathing reduces the oxygen saturation in blood leading to a cycle of various systemic implications. Hence, a prospective single arm study was planned to evaluate the long-term (2 years) effect of oral appliance on cardiovascular fitness and psychomotor performance in patients with mild to moderate obstructive sleep apnea...
July 10, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28646811/alternative-therapy-for-patients-with-obstructive-sleep-apnea-hypopnea-syndrome-a-1-year-single-blind-randomized-trial-of-tui-na
#9
Cheng-Nan Lu, Michael Friedman, Hsin-Ching Lin, Kuo-Wei Bi, Tun-Pin Hsueh, Hsueh-Wen Chang, Mao-Chang Su, Meng-Chih Lin
Context • Obstructive sleep apnea/hypopnea syndrome (OSAHS) is among the most prevalent of sleep-related breathing disorders. No long-term follow-up studies have documented the continued success of lifestyle changes in treatment; oral appliances have an approximate 50% success rate; compliance with continuous positive airway pressure is poor, ranging from 50% to 89%; and the success rate of upper-airway surgery is only 66.4%. Therefore, some OSAHS patients seek alternative treatments. Objectives • The study intended to examine the efficacy of traditional Chinese therapeutic massage (tui na) for patients with OSAHS...
July 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28645668/titration-technique-using-endoscopy-for-an-oral-appliance-treatment-of-obstructive-sleep-apnea
#10
Kentaro Okuno, Kazuki Ikai, Erika Matsumura-Ai, Takafumi Araie
The degree of mandibular protrusion for an oral appliance (OA) should be customized for each patient with obstructive sleep apnea (OSA). This article describes the mandibular titration technique for OAs to effectively treat OSA by using endoscopy to evaluate the change in the airway at the velopharynx. This technique may minimize the degree of mandible protrusion and contribute to both the efficacy of and compliance with OA therapy.
June 20, 2017: Journal of Prosthetic Dentistry
https://www.readbyqxmd.com/read/28629917/personalized-management-approach-for-osa
#11
REVIEW
Jayne C Carberry, Jason Amatoury, Danny J Eckert
OSA is a heterogeneous disorder. If left untreated, it has major health, safety, and economic consequences. In addition to varying levels of impairment in pharyngeal anatomy (narrow/collapsible airway), nonanatomical "phenotypic traits" are also important contributors to OSA for most patients. However, the majority of existing therapies (eg, CPAP, oral appliances, weight loss, positional therapy, upper airway surgery) target only the anatomical cause. These are typically administered as monotherapy according to a trial and error management approach in which the majority of patients are first prescribed CPAP...
June 16, 2017: Chest
https://www.readbyqxmd.com/read/28624182/oral-appliances-for-the-management-of-osa-an-updated-review-of-the-literature
#12
REVIEW
Mona M Hamoda, Yuuya Kohzuka, Fernanda R Almeida
Oral appliances (OAs) are becoming increasingly recognized not only as an alternative, but also possibly as an adjunct treatment modality for obstructive sleep apnea (OSA). Compared to Continuous Positive Airway Pressure (CPAP), the gold standard therapy, OAs are less efficacious but are more accepted and tolerated by the patients which may in turn lead to a comparable therapeutic effectiveness. Different oral appliance designs currently exist and even more are constantly emerging. Additionally, state of the art technologies are being utilized in the fabrication of many however, all the currently available OAs employ the same mechanism of action by targeting the anatomical component involved in the pathogenesis of the disease...
June 14, 2017: Chest
https://www.readbyqxmd.com/read/28522078/a-randomized-controlled-trial-of-positional-therapy-versus-oral-appliance-therapy-for-position-dependent-sleep-apnea
#13
Linda Benoist, Maurits de Ruiter, Jan de Lange, Nico de Vries
OBJECTIVE: To compare the effectiveness of positional therapy (PT) with the sleep position trainer (SPT) to oral appliance therapy (OAT) in patients with mild-to-moderate positional obstructive sleep apnea (POSA). METHODS: Multicenter, prospective, randomized, controlled trial. Patients with mild-to-moderate POSA (apnea-hypopnea index (AHI) ≥5 ≤ 30/hour sleep) were randomized for PT or OAT. Polysomnography was repeated after 3 months. Efficacy, adherence, mean disease alleviation (MDA), quality of life, dropouts and adverse events were evaluated...
June 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28502280/a-feedback-controlled-mandibular-positioner-identifies-individuals-with-sleep-apnea-who-will-respond-to-oral-appliance-therapy
#14
John E Remmers, Zbigniew Topor, Joshua Grosse, Nikola Vranjes, Erin V Mosca, Rollin Brant, Sabina Bruehlmann, Shouresh Charkhandeh, Seyed Abdolali Zareian Jahromi
STUDY OBJECTIVES: Mandibular protruding oral appliances represent a potentially important therapy for obstructive sleep apnea (OSA). However, their clinical utility is limited by a less-than-ideal efficacy rate and uncertainty regarding an efficacious mandibular position, pointing to the need for a tool to assist in delivery of the therapy. The current study assesses the ability to prospectively identify therapeutic responders and determine an efficacious mandibular position. METHODS: Individuals (n = 202) with OSA participated in a blinded, 2-part investigation...
July 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28454604/collaboration-guidelines-between-sleep-physicians-and-dentists-in-the-management-of-obstructive-sleep-apnea-an-american-academy-of-dental-sleep-medicine-and-american-academy-of-sleep-medicine-joint-position-statement
#15
Kannan Ramar, James A Rowley, Stuart F Quan, Kathleen M Bennett, Alan Blanton, Kelly A Carden, Ronald D Chervin, Leslie Dort, Douglas B Kirsch, David A Kristo, Mitchell Levine, Raman K Malhotra, Jennifer L Martin, Eric J Olson, Kevin Postol, Ilene M Rosen, Thomas Schell, David Schwartz, Rose Sheats, Harold Smith, Nathaniel F Watson, Terri E Weaver
The boards of directors of the American Academy of Dental Sleep Medicine (AADSM) and the American Academy of Sleep Medicine (AASM) approved this position statement to provide more detailed clarification regarding the appropriate role of dentists and physicians, respectively, in the treatment and ongoing management of obstructive sleep apnea (OSA) using oral appliance therapy (OAT). In order to promote high quality, patient-centered care for patients who have chosen OAT, and to effectively and collaboratively manage these patients, dentists and sleep physicians should follow the recommendations in the updated clinical practice guideline for the treatment of OSA and snoring with OAT, which was published jointly by the AADSM and AASM in 2015...
April 25, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28422345/therapeutic-efficacy-of-twin-block-and-fixed-oral-appliances-in-patients-with-obstructive-sleep-apnea-syndrome
#16
George Umemoto, Hideo Toyoshima, Yuji Yamaguchi, Naoko Aoyagi, Chikara Yoshimura, Kouta Funakoshi
PURPOSE: To compare the efficacy of twin-block (i.e., allows mouth opening) and fixed (i.e., maintains mouth closure) mandibular advancement splints (MASs) for the treatment of obstructive sleep apnea-hypopnea syndrome (OSA). MATERIALS AND METHODS: From 2011 to 2013, 23 patients with OSA in the twin-block group, and from 2013 to 2015, 29 patients in the fixed MAS group were included. All patients underwent polysomnography before and after 3 months of treatment. The two sets of polysomnographic and cephalometric variables were compared...
April 19, 2017: Journal of Prosthodontics: Official Journal of the American College of Prosthodontists
https://www.readbyqxmd.com/read/28356131/treatment-of-infants-with-syndromic-robin-sequence-with-modified-palatal-plates-a-minimally-invasive-treatment-option
#17
Silvia Müller-Hagedorn, Wolfgang Buchenau, Jörg Arand, Margit Bacher, Christian F Poets
BACKGROUND: Infants with Robin sequence (RS) suffer from upper airway obstruction (UAO) and feeding problems. We developed an oral appliance with a velar extension in combination with functional treatment and appropriate feeding techniques, which was proven effective in isolated RS. As the above problems are particularly challenging in syndromic RS, we set out to evaluate our treatment concept also in these patients. METHODS: We searched our electronic departmental database to identify all children admitted to our department between 01/01/2003 and 31/12/2009 because of syndromic RS...
March 30, 2017: Head & Face Medicine
https://www.readbyqxmd.com/read/28294380/oral-appliance-therapy-versus-nasal-continuous-positive-airway-pressure-in-obstructive-sleep-apnoea-syndrome-a-randomised-placebo-controlled-trial-on-self-reported-symptoms-of-common-sleep-disorders-and-sleep-related-problems
#18
M Nikolopoulou, A Byraki, J Ahlberg, M W Heymans, H L Hamburger, J De Lange, F Lobbezoo, G Aarab
Obstructive sleep apnoea syndrome (OSAS) is associated with several sleep disorders and sleep-related problems. Therefore, the aim of this study was to compare the effects of a mandibular advancement device (MAD) with those of nasal continuous positive airway pressure (nCPAP) on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. In this randomised placebo-controlled trial, sixty-four OSAS patients (52·0 ± 9·6 years) were randomly assigned to an MAD, nCPAP or an intra-oral placebo appliance in a parallel design...
June 2017: Journal of Oral Rehabilitation
https://www.readbyqxmd.com/read/28287009/continuous-positive-airway-pressure-therapy-in-obstuctive-sleep-apnea-benefits-and-alternatives
#19
REVIEW
Michelle T Cao, Joshua M Sternbach, C Guilleminault
Obstructive sleep apnea (OSA) is a highly prevalent condition affecting persons of all age with an increasing public health burden. It is implicated in cardiovascular disease, metabolic syndrome, neurocognitive impairment, reductions in quality of life, and increased motor vehicle accidents. The goals of OSA treatment are to improve sleep and daytime symptoms, and minimize cardiovascular risks.Areas covered: Continuous positive airway pressure (CPAP) is considered the gold standard therapy that delivers pressurized air into the upper airway to relieve obstruction during sleep...
April 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28228337/minimizing-the-mandibular-advancement-in-an-oral-appliance-for-the-treatment-of-obstructive-sleep-apnea
#20
Eduardo Anitua, Joaquín Durán-Cantolla, Gabriela Zamora Almeida, Mohammad Hamdan Alkhraisat
OBJECTIVE: In the treatment of obstructive sleep apnea (OSA) with an oral appliance (OA), there is no gold standard method to fine-tune the mandibular advancement. This study aimed to analyze the effect of gradual increment of mandibular advancement on the evolution of the apnea-hypopnea index (AHI). METHODS: OSA patients were recruited from a sleep unit. All treatments started with an oral appliance without mandibular advancement. After two weeks, the AHI was assessed with respiratory polygraphy...
January 29, 2017: Sleep Medicine
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