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https://www.readbyqxmd.com/read/28738391/updated-palate-surgery-for-obstructive-sleep-apnea
#1
Hsueh-Yu Li
Initially described in 1981, uvulopalatopharyngoplasty was the first surgical procedure specially designed at the palatal level for snoring and obstructive sleep apnea (OSA). To date, palatal surgery remains the most commonly used surgery for OSA. The advancement of this surgery over the past 30 years has been a process of evolution in concepts, examination, and technique to increase safety and effectiveness in the treatment of OSA. Concept changes have emerged in the disease etiology, purpose of surgery, treatment priorities, staging of operations, integration therapy, and surgical endpoints...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738374/multilevel-obstructive-sleep-apnea-surgery
#2
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
#3
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/28738371/robotic-obstructive-sleep-apnea-surgery
#4
Song Tar Toh, Pon Poh Hsu
Since the first report of the use of the da Vinci robotic system (Intuitive Surgical, Sunnyvale, CA, USA) in transoral robotic tongue base reduction for obstructive sleep apnea (OSA) was published in 2010, this surgical tool and technique has been used worldwide for the resection of tongue base tissue in the multilevel surgical treatment of OSA. The combined knowledge of the published literature on its use has enlightened sleep surgeons worldwide on this new yet evolving surgical tool. Here we will discuss the use of the da Vinci robotic system in the treatment of OSA, the pertinent surgical anatomy for a safe surgical procedure, the primary and secondary outcomes to expect in the multilevel and primary use of this technology in treating the tongue base, the predictors for success or failure, and the complications associated with this technique...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738358/innovative-surgery-for-obstructive-sleep-apnea-nerve-stimulator
#5
J Ulrich Sommer, Karl Hörmann
Obstructive sleep apnea (OSA) as a multifactorial disease is treated with continuous positive airway pressure (CPAP) as the gold standard. Yet, if patients suffer from CPAP incompliance, traditional OSA surgery only targets morphological changes of the upper airway while neglecting functional issues. With the advent of upper airway stimulation, and in particular hypoglossal nerve stimulation as a treatment option, a highly effective, clinically proven and functional therapy with good evidence is available. This article gives a comprehensive overview of current and upcoming hypoglossal nerve stimulation systems (Inspire, ImThera, and Nyxoah), the specific advantages of this approach, the selection criteria and screening process, relevant clinical data, and a description of the different implantation procedures...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738340/novel-positional-devices-for-the-treatment-of-positional-obstructive-sleep-apnea-and-how-this-relates-to-sleep-surgery
#6
Madeline J L Revesloot, Linda Benoist, Peter van Maanen, Nico de Vries
If untreated, obstructive sleep apnea (OSA) develops as a gradual progressive disease. In the early stage of the disease most patients with OSA are positional. The archetypical patient might progress from simple positional snoring via positional early-stage mild disease to less positional moderate and finally nonpositional severe OSA. At first, the apnea-hypopnea index (AHI) is high only in the supine position, and later is high in all sleeping positions. The phenomenon is reversible. After partial effective treatment, patients with severe OSA can reverse to less severe positional OSA or, in other words, the AHI drops more in the lateral position than in supine position...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738337/the-history-of-sleep-surgery
#7
Kathleen Yaremchuk, Laura Garcia-Rodriguez
Snoring and the subsequent diagnosis of obstructive sleep apnea (OSA) was a life-threatening medical condition with no available treatment until the late 20th century. An early description of OSA was provided by Charles Dickens in his 1836 novel Pickwick Papers with the description of a "fat boy" who was thought to be lazy and always falling asleep but likely displayed hypersomnolence from OSA. It was not until 1976 that Ikematsu first described uvulopalatopharyngoplasty (UPPP) as an alternative surgical treatment of "snoring," with a reported cure rate of 81%...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738322/pediatric-obstructive-sleep-apnea-where-do-we-stand
#8
Yu-Shu Huang, Christian Guilleminault
Pediatric obstructive sleep apnea (OSA) was initially described in 1976. In 1981, Dr. Guilleminault emphasized that pediatric OSA was different from the clinical presentation reported in adults. It was characterized by more disturbed nocturnal sleep than excessive daytime sleepiness, and presented more behavioral problems, particularly school problems, hyperactivity, nocturnal enuresis, sleep terrors, depression, insomnia, and psychiatric problems. The underlying causes of pediatric OSA are complex. Such factors as adenotonsillar hypertrophy, obesity, anatomical and neuromuscular factors, and hypotonic neuromuscular disease are also involved...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28735924/obstructive-sleep-apnea-effect-of-comorbidities-and-positive-airway-pressure-on-all-cause-mortality
#9
Poul Jennum, Philip Tønnesen, Rikke Ibsen, Jakob Kjellberg
OBJECTIVE: Most studies have used cardiovascular and cerebrovascular disease (CVD) end-points to measure the effect of continuous positive airway pressure (CPAP), but pre-diagnostic morbidities involve a range of comorbidities that may influence the consequences of obstructive sleep apnea (OSA). We therefore aimed to evaluate all-cause total mortality after a diagnosis of OSA, the effect of CPAP in women and men, and the potential effect of major comorbidities. METHODS: We used national registry data as a historical cohort and included 22,135 OSA patients aged 20 years or more with comorbidity data three years before diagnosis and follow-up morbidity and mortality over a period of 17 years...
August 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28735907/the-relationship-between-weight-change-and-daytime-sleepiness-the-sleep-heart-health-study
#10
Winda L Ng, Liliana Orellana, Jonathan E Shaw, Evelyn Wong, Anna Peeters
OBJECTIVE: Through a causal framework, we aim to assess the association between weight change and daytime sleepiness, and the role of obstructive sleep apnoea (OSA) in this relationship. METHODS: From the Sleep Heart Health Study, we selected individuals who were: (1) 40-64 years old, with (2) body mass index (BMI) ≥18.5 kg/m(2), (3) no history of stroke, treatment for OSA, and tracheostomy at baseline. We used multiple linear regression to assess the relationship between five-year weight change and daytime sleepiness (assessed through Epworth Sleepiness Scale (ESS)) at five years, adjusting for daytime sleepiness, demographics, diabetes, subjective sleep duration, sleep disturbance, smoking status, weight, and use of antidepressants and benzodiazepines at baseline, in those with complete data (N = 1468)...
August 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28735905/awareness-and-knowledge-of-obstructive-sleep-apnea-among-the%C3%A2-general-population
#11
Ching-Hui Sia, Yueheng Hong, Linda W L Tan, Rob M van Dam, Chi-Hang Lee, Adeline Tan
BACKGROUND: Obstructive sleep apnea (OSA) is an increasingly prevalent condition that remains largely undiagnosed. We aimed to assess the level of awareness and knowledge of OSA among the general population. METHODS: The Singapore Health 2 was a population-based study that comprised interview and health screening components. Out of 2720 subjects who completed the interview component, 2080 subjects gave consent for further health surveys. We contacted these subjects and conducted a structured telephone interview...
August 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28728621/high-flow-heated-humidified-air-via-nasal-cannula-treats-cpap-intolerant-children-with-obstructive-sleep-apnea
#12
Stephen Hawkins, Stephanie Huston, Kristen Campbell, Ann Halbower
STUDY OBJECTIVES: Continuous positive airway pressure (CPAP) is effective but challenging for children with obstructive sleep apnea (OSA). High-flow air via open nasal cannula (HFNC) as treatment in children remains controversial. We report the efficacy of HFNC in children with OSA and CPAP intolerance, a titration protocol, and a discussion of potential mechanisms. METHODS: Patients aged 1 to 18 years with OSA (defined by obstructive apnea-hypopnea index [OAHI] greater than 1 event/h) and CPAP intolerance were enrolled...
July 14, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28728616/efficacy-of-the-addition-of-a-cervical-collar-in-the-treatment-of-persistent-obstructive-apneas-despite-continuous-positive-airway-pressure
#13
Arnaud Prigent, Leo Grassion, Stephanie Guesdon, Jesus Gonzalez-Bermejo
Continuous positive airway pressure (CPAP) is currently the reference treatment for obstructive sleep apnea (OSA). The use of a face mask, although sometimes necessary, is often associated with increased airway obstruction due to mandibular retrusion. We report a small group of patients in whom addition of a cervical collar to a face mask allowed correction of obstructive events.
July 14, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28724876/treatment-with-continuous-positive-airway-pressure-and-diurnal-and-nocturnal-serum-melatonin-concentration-in-patients-with-obstructive-sleep-apnea
#14
Małgorzata Barnaś, Marta Maskey-Warzęchowska, Piotr Bielicki, Marta Kumor, Ryszarda Chazan
INTRODUCTION    Melatonin secretion, one of the main factors controlling the sleep-wake rhythm, may be disrupted in subjects with sleep disorders. OBJECTIVES    To evaluate the profile of circadian melatonin secretion in patients with obstructive sleep apnea (OSA) and to assess the impact of a 2 day and a 3-month period of treatment with continuous airway pressure (CPAP) on diurnal and nocturnal serum melatonin. PATIENTS AND METHODS    Serum melatonin was evaluated in 71 untreated OSA patients and 18 healthy controls at six time points: 10 am, 2 pm, 6 pm, 10 pm, 2 am, 6 am...
July 10, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28718463/-chewing-on-bruxism-associations-consequences-and-management
#15
F Lobbezoo, R Jacobs, A DE Laat, G Aarab, P Wetselaar, D Manfredini
In this second part of a diptych on bruxism, the focus is on the associations of this masticatory muscle activity with other sleep-related conditions. Its association with the obstructive sleep apnoea syndrome (OSAS) has been a particular object of study. Bruxism seems to play a protective role in OSAS, although the evidence for this is not yet conclusive. Apart from this possible positive consequence, bruxism also has several negative consequences, for which evidence is available to a greater or lesser extent...
July 2017: Nederlands Tijdschrift Voor Tandheelkunde
https://www.readbyqxmd.com/read/28714872/immunomodulatory-activity-of-octenyl-succinic-anhydride-modified-porang-amorphophallus-oncophyllus-glucomannan-on-mouse-macrophage-like-j774-1-cells-and-mouse-primary-peritoneal-macrophages
#16
Sellen Gurusmatika, Kosuke Nishi, Eni Harmayani, Yudi Pranoto, Takuya Sugahara
Porang is a local plant of Indonesia, which has a high content of glucomannan. In this study, porang glucomannan (PG) was esterified with octenyl succinic anhydride (OSA) to enhance emulsion properties to be widely used in food industry. OSA-modified PG (OSA-PG) enhanced the phagocytosis activity of macrophage-like J774.1 cells and mouse peritoneal macrophages. In addition, OSA-PG increased the production of IL-6 and TNF-α by enhancing their gene expression. Immunoblot analysis displayed that OSA-PG tended to activate both nuclear factor-κB and mitogen-activated protein kinase cascades...
July 15, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28707161/a-weight-independent-association-between-atypical-antipsychotic-medications-and-obstructive-sleep-apnea
#17
Habibolah Khazaie, Amir Sharafkhaneh, Sepideh Khazaie, Mohammad Rasoul Ghadami
BACKGROUND: With increasing use of atypical antipsychotic (AAP) agents, the concern has been raised about the association between AAP agents and medical complications. Obstructive sleep apnea (OSA) is a common breathing disorder that adversely affects health and quality of life. Because the major risk factors for OSA are weight gain and obesity by altering the upper airway anatomy, an association between AAP and development of OSA is predictable. However, we hypothesized that AAP may promote OSA not only by weight gain but also because of its potential effects on upper airway muscle function...
July 13, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28704678/the-role-of-microbial-diversity-and-composition-in-minimizing-sludge-production-in-the-oxic-settling-anoxic-process
#18
Galilee U Semblante, Hop V Phan, Faisal I Hai, Zhi-Qiang Xu, William E Price, Long D Nghiem
The oxic-settling-anoxic (OSA) process, which involves an aerobic tank attached to oxygen- and substrate-deficient external anoxic reactors, minimizes sludge production in biological wastewater treatment. In this study, the microbial community structure of OSA was determined. Principal coordinate analysis showed that among the three operational factors, i.e., (i) redox condition, (ii) external reactor sludge retention time (SRText), and (iii) sludge interchange between aerobic and anoxic reactors, redox condition had the greatest impact on microbial diversity...
July 10, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28702829/severe-obstructive-sleep-apnea-treatment-with-oral-appliance-the-impact-on-obstructive-central-and-mixed-events
#19
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
#20
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
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