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Oral Appliance for Sleep Apnea

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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
#1
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
#2
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-obstructive-sleep-apnea
#3
REVIEW
Jayne C Carberry, Jason Amatoury, Danny J Eckert
Obstructive sleep apnea (OSA) is a heterogeneous disorder. If left untreated, OSA has major health, safety and economic consequences. In addition to varying levels of impairment in pharyngeal anatomy (narrow/collapsible airway), non-anatomical 'phenotypic traits' are also important contributors to OSA for most patients. However, the majority of existing therapies only target the anatomical cause (e.g. continuous positive airway pressure [CPAP], oral appliances, weight loss, positional therapy, and upper airway surgery)...
June 16, 2017: Chest
https://www.readbyqxmd.com/read/28624182/oral-appliances-for-the-management-of-osa-an-updated-review-of-the-literature
#4
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
#5
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
#6
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...
May 11, 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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28215005/effect-of-bite-openings-and-mandibular-protrusion-on-genioglossus-muscle-activity-in-healthy-adults-with-oral-appliance
#13
Jianlan Long, Toru Ogawa, Toshimi Ito, Michikazu Matsuda, Wei Li, Haiyang Yu, Keiichi Sasaki
Oral appliance (OA) can effectively treat obstructive sleep apnea; however, numerous types of oral appliances and designs are variable and the precise mechanisms behind differences in treatment outcomes are uncertain. The objective of this study was to evaluate the effects of different degrees of mandibular position [4° of bite openings (BO): 2, 4, 8 and 12 mm; and protrusion (P): 0, 50%, MAX], for both the upright and supine positions: BO2 mm_P0%, BO4 mm_P0%, BO4 mm_P50%, BO4 mm_PMAX, BO8 mm_P0%, BO12 mm_P0%; with an OA on the: (1) activity of the genioglossus (GG) muscle by electromyogram, (2) inspiration by airflow sensor, and (3) recording mandibular movements (incisor and mandibular condyle point) in each position...
February 18, 2017: Odontology
https://www.readbyqxmd.com/read/28203016/-efficacy-of-oral-appliance-therapy-of-obstructive-sleep-apnea-and-hypopnea-syndrome-in-different-periods-of-treatment
#14
X Gong, Y Zhao, W R Li, X M Gao
OBJECTIVE: To investigate the long-term efficacy of oral appliance treating of obstructive sleep apnea and hypopnea syndrome (OSAHS) in different periods of treatment. METHODS: A total of 55 patients were included in the study. Patients were all diagnosed with OSAHS by overnight polysomnography and all received oral appliance (OA) as the therapy. The OA positioned the mandible at 60%-70% of the maximal mandible advancement position and created a 4-5 mm incisor separation...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28126502/-therapeutic-alternatives-to-continuous-positive-airway-pressure-for-obstructive-sleep-apnea-hypopnea-syndrome
#15
Frédéric Gagnadoux, Marie Jouvenot, Nicole Meslier, Pascaline Priou, Wocjiech Trzepizur
Oral appliance therapy (OAT) is the main therapeutic alternative to continuous positive airway pressure (CPAP). OAT has been recommended as an appropriate first-line treatment option for moderate obstructive sleep apnea-hypopnea syndrome (OSAHS) in patients without severe cardiovascular comorbidity. The lower efficacy of OAT in reducing sleep-disordered breathing could be offset by a higher compliance relative to CPAP, resulting in similar health outcomes in terms of sleepiness, neurobehavioral functioning, quality of life and blood pressure...
January 23, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28116544/changes-in-lower-incisor-irregularity-during-treatment-with-oral-sleep-apnea-appliances
#16
Niclas Norrhem, Hans Nemeczek, Marie Marklund
PURPOSE: The purpose of this study is to test the hypothesis that a flexible oral appliance without incisor coverage (OAFlex) increases the irregularity of the front teeth compared with a rigid appliance with incisor coverage (OARigid) in patients treated for obstructive sleep apnea (OSA). METHOD AND PATIENTS: Nineteen patients (10 men) who had used OARigid and 22 patients (19 men) who had used OAFlex with a median age of 61 years (IQR of 56 to 67 years) who had been treated during a median period of 2...
January 23, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28095973/impact-of-obstructive-sleep-apnea-and-its-treatments-on-partners-a-literature-review
#17
Faith S Luyster
STUDY OBJECTIVES: Many adults sleep with a significant other; thus, sleep disorder symptoms and treatments of one partner are likely to impact the other partner's health. A literature review was conducted to examine the impact of obstructive sleep apnea (OSA) and OSA treatments on partner-assessed sleep and daytime functioning and partner involvement in OSA treatment. METHODS: MEDLINE, EMBASE, and CINAHL searches yielded 38 pertinent quantitative and qualitative studies that described sleep and/or daytime functioning assessed in partners of patients with untreated OSA, sleep and/or daytime functioning assessed in partners who were referred for OSA treatment, including continuous positive airway pressure (CPAP) therapy, oral appliance (OA), or surgery, and/or associations between partner involvement and OSA treatment use...
March 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28063976/effect-of-jaw-opening-exercise-on-prevention-of-temporomandibular-disorders-pain-associated-with-oral-appliance-therapy-in-obstructive-sleep-apnea-patients-a-randomized-double-blind-placebo-controlled-trial
#18
Hiroyuki Ishiyama, Shusuke Inukai, Akira Nishiyama, Masayuki Hideshima, Shuhei Nakamura, Meiyo Tamaoka, Yasunari Miyazaki, Kenji Fueki, Noriyuki Wakabayashi
PURPOSE: There are no studies on the prevention of temporomandibular joint and/or masticatory muscle pain (TMD pain) associated with oral appliance (OA) therapy in patients with obstructive sleep apnea (OSA). The aim of this study was to determine the effect of jaw-opening exercise on TMD pain associated with OA therapy in OSA patients. METHODS: Twenty-five OSA patients without pain-related TMD were consecutively enrolled into a two-arm, randomized, double-blind, placebo-controlled trial...
January 4, 2017: Journal of Prosthodontic Research
https://www.readbyqxmd.com/read/28054437/assessment-of-interfering-factors-in-non-adherence-to-oral-appliance-therapy-in-severe-sleep-apnea
#19
Y Haviv, A Zini, G Almoznino, N Keshet, Y Sharav, D J Aframian
OBJECTIVE: Oral appliances (OA) are recommended for patients with severe obstructive sleep apnea who fail to comply with continuous positive airway pressure (CPAP) therapy. This mixed-methods study aimed to quantify adherence to OA therapy and evaluate subjective reasons associated with non-adherence. MATERIALS AND METHODS: The medical records of 52 patients with an apnea-hypopnea index (AHI) ≥ 40, treated with OA after discontinuation of CPAP treatment, were examined for OA adherence...
January 5, 2017: Oral Diseases
https://www.readbyqxmd.com/read/27923436/performance-of-remotely-controlled-mandibular-protrusion-sleep-studies-for-prediction-of-oral-appliance-treatment-response
#20
Kate Sutherland, Joachim Ngiam, Peter A Cistulli
STUDY OBJECTIVES: Mandibular protrusion during sleep monitoring has been proposed as a method to predict oral appliance treatment outcome. A commercial remotely controlled mandibular protrusion (RCMP) device has become available for this purpose with predictive accuracy demonstrated in an initial study. Our aim was to validate this RCMP method for oral appliance treatment outcome prediction in a clinical sleep laboratory setting. METHODS: Forty-two obstructive sleep apnea (OSA) patients (apnea-hypopnea index [AHI] > 10 events/h) were recruited to undergo a RCMP sleep study before commencing oral appliance treatment...
March 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
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