Non-CPAP therapies in obstructive sleep apnoea
Winfried Randerath,Johan Verbraecken,S. Andreas,Georges Bettega,An Boudewyns,Evert Hamans,F Jalbert,J R Paoli,Bernd Sanner,Ian Smith,Boris A. Stuck,L Lacassagne,Marie Marklund,Joachim T. Maurer,Jean-Louis Pépin,A Valipour,Thomas Verse,Ingo Fietze +17 more
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TLDR
Evidence supports the use of mandibular advancement devices in mild to moderate OSAS and Maxillomandibular osteotomy seems to be as efficient as continuous positive airway pressure (CPAP) in patients who refuse conservative treatment.Abstract:
In view of the high prevalence and the relevant impairment of patients with obstructive sleep apnoea syndrome (OSAS) lots of methods are offered which promise definitive cures for or relevant improvement of OSAS. This report summarises the efficacy of alternative treatment options in OSAS. An interdisciplinary European Respiratory Society task force evaluated the scientific literature according to the standards of evidence-based medicine. Evidence supports the use of mandibular advancement devices in mild to moderate OSAS. Maxillomandibular osteotomy seems to be as efficient as continuous positive airway pressure (CPAP) in patients who refuse conservative treatment. Distraction osteogenesis is usefully applied in congenital micrognathia or midface hypoplasia. There is a trend towards improvment after weight reduction. Positional therapy is clearly inferior to CPAP and long-term compliance is poor. Drugs, nasal dilators and apnoea triggered muscle stimulation cannot be recommended as effective treatments of OSAS at the moment. Nasal surgery, radiofrequency tonsil reduction, tongue base surgery, uvulopalatal flap, laser midline glossectomy, tongue suspension and genioglossus advancement cannot be recommended as single interventions. Uvulopalatopharyngoplasty, pillar implants and hyoid suspension should only be considered in selected patients and potential benefits should be weighed against the risk of long-term side-effects. Multilevel surgery is only a salvage procedure for OSA patients.read more
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Journal ArticleDOI
Obstructive sleep apnoea syndrome
Patrick Levy,Malcolm Kohler,Walter T. McNicholas,Ferran Barbé,R. Doug McEvoy,Virend K. Somers,Lena Lavie,Jean-Louis Pépin +7 more
TL;DR: Continuous positive airway pressure (CPAP) is the primary treatment modality in patients with severe OSAS, whereas oral appliances are also widely used in mild to moderate forms, and combining different treatment modalities such as CPAP and weight control is beneficial, but need to be evaluated in randomized controlled trials.
Journal ArticleDOI
Myofunctional Therapy to Treat Obstructive Sleep Apnea: A Systematic Review and Meta-analysis
Macario Camacho,Victor Certal,Jose Abdullatif,Soroush Zaghi,Chad Ruoff,Robson Capasso,Clete A. Kushida +6 more
TL;DR: Current literature demonstrates that myofunctional therapy decreases apnea-hypopnea index by approximately 50% in adults and 62% in children and could serve as an adjunct to other obstructive sleep apnea treatments.
Journal ArticleDOI
Obstructive sleep apnoea syndrome and its management
TL;DR: After more than three decades from its first use, continuous positive airway pressure (CPAP) is still recognized as the gold standard treatment and is highly effective in controlling symptoms, improving quality of life and reducing the clinical sequelae of sleep apnoea.
Journal ArticleDOI
Implanted upper airway stimulation device for obstructive sleep apnea
Paul Van de Heyning,M. Safwan Badr,Jonathan Z. Baskin,Michel A. Cramer Bornemann,Wilfried De Backer,Yaniv Dotan,Winfried Hohenhorst,Lennart Knaack,Ho-Sheng Lin,Ho-Sheng Lin,Joachim T. Maurer,Aviram Netzer,Rick M. Odland,Arie Oliven,Kingman P. Strohl,Olivier M. Vanderveken,Johan Verbraecken,B. Tucker Woodson +17 more
TL;DR: The safety and preliminary effectiveness of a second generation device, the Upper Airway Stimulation (UAS) system, is examined, and baseline predictors for therapy success are identified.
Journal ArticleDOI
The undervalued potential of positional therapy in position-dependent snoring and obstructive sleep apnea—a review of the literature
TL;DR: Long-term compliance for PT remains an issue, and although remarkable results have been shown using innovative treatment concepts for PT, there is room for both technical improvement of the devices and for further research.
References
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Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study
TL;DR: In men, severe obstructive sleep apnoea-hypopNoea significantly increases the risk of fatal and non-fatal cardiovascular events and CPAP treatment reduces this risk.
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Journal ArticleDOI
Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares
TL;DR: Five patients with severe obstructive sleep apnoea were treated with continuous positive airway pressure (CPAP) applied via a comfortable nose mask through the nares, which provides a pneumatic splint for the nasopharyngeal airway and is a safe, simple treatment for the obstructiveSleep apNoea syndrome.