Newer treatment modalities for pediatric obstructive sleep apnea

Obstructive sleep apnea (OSA) has become a health issue of high prevalence. The prevalence is rising between 1990-2010 by approximately 30%, with absolute increases of 4.2% in women and 7.5% in men. This condition is characterized by a breathing disorder of partial or complete upper airway obstruction leading to increased resistance to airflow and potential cessation of breathing during sleep. Its multifactorial etiology Such etiologies involve obesity, craniofacial anatomy, and the use of stimulants and medications to reduce muscle tension. This review aims to summarize the recent diagnosis and treatment modalities of OSA. The database PubMed and google scholar were searched for relevant published records. A total of 39 articles were collected randomly limited to the English language. We placed no restrictions on the date of publication. Evidence from methodological studies indicate that undiagnosed OSA is associated with hypertension, cardiovascular disease, stroke, and daytime sleepiness. Thorough clinical and instrumental examinations should precede a proper diagnosis selection. The primary goal of treatment is reducing the Patient’s symptoms, depending on the severity of the patient’s condition. OSA can be treated in different ways, including behavioral therapy, medical device, surgery, and pharmacological therapies. There are limitations in dental school about education and training of OSA and oral appliances (OA). OSA teamwork must include both qualified sleep physicians and dentists. The Orthodontist plays a critical role in evaluating and treating OSA patients, choosing the right oral appliance, and assessing and adjusting the appliance.

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Mandibular Advancement Device use for therapy of simple snoring: mini review

Romanian Journal of Rhinology ◽

10.2478/rjr-2021-0006 ◽

2021 ◽

Vol 11 (41) ◽

pp. 30-33

Author(s):

Erdem Atalay Cetinkaya

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Upper Airway ◽

Mandibular Advancement Device ◽

Mandibular Advancement ◽

Treatment Modalities ◽

Upper Airways ◽

Obstructive Sleep ◽

Surgical Methods ◽

Simple Snoring

AbstractOral devices that treat obstructive sleep apnea are an easy and influential option to protect the upper airways from sleep obstructions. One example is the mandibular advancement device (MAD), which is a non-invasive apparatus specified in adults with simple snoring and mild obstructive sleep apnea. Recently, due to the constraints of other therapies, like positive airway pressure treatment and surgical methods, there has been growing interest in the use of oral appliance for simple snoring patients. MAD is managed to improve the upper airway volume, minimize upper airway collapse and reduce snoring. On the other hand, it remains inferior to CPAP in the reduction of the apnea-hypopnea scores, with therapy success varying from 24% to 72%. The treatment modalities include skilled physicians and multidisciplinary strategies to treat patients with snoring and obstructive sleep apnea (OSA) effectively. Some researchers also suggest potential predictors of progress in care, but specific criteria for patient selection and predictive clinical principles for effectiveness in all treatment modalities are still needed. The aim of this brief clinical Study is to review MAD brief history, design, indications, contraindications, therapy efficiency, side effects, and current perspectives.

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Neurobiology of Obstructive Sleep Apnea

10.1093/acrefore/9780190264086.013.31 ◽

2021 ◽

Author(s):

Steven Holfinger ◽

M. Melanie Lyons ◽

Nitin Bhatt ◽

Ulysses Magalang

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Current Treatment ◽

Treatment Modalities ◽

Sleep Stages ◽

Critical Importance ◽

Obstructive Sleep ◽

The Impact ◽

Underlying Risk ◽

Pathophysiologic Mechanisms

Obstructive sleep apnea is recognized as a heterogeneous disease presenting with varying underlying risk factors, phenotypes, and responses to therapy. This clinical variance is in part due to the complex pathophysiology of sleep apnea. While multiple anatomical issues can predispose to the development of sleep apnea, factors that control the airway musculature also contribute via different pathophysiologic mechanisms. As sleep apnea does not occur during wakefulness, the impact of sleep stages on respiration is of critical importance. Altogether, understanding sleep apnea pathophysiology helps to guide current treatment modalities and helps identify potential targets for future therapies.

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Drug-Induced Sleep Endoscopy: Evaluation of a Selection Tool for Treatment Modalities for Obstructive Sleep Apnea

Respiration ◽

10.1159/000505584 ◽

2020 ◽

Vol 99 (5) ◽

pp. 451-457 ◽

Cited By ~ 2

Author(s):

Anneclaire V. Vroegop ◽

Olivier M. Vanderveken ◽

Johan A. Verbraecken

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Treatment Modalities ◽

Sleep Endoscopy ◽

Drug Induced ◽

Selection Tool ◽

Drug Induced Sleep Endoscopy ◽

Obstructive Sleep

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Obstructive Sleep Apnea: A Dental Perspective

International Healthcare Research Journal ◽

10.26440/ihrj/0308.11250 ◽

2019 ◽

Vol 3 (8) ◽

pp. 260-266

Author(s):

CM Marya ◽

Sonam Jain ◽

Ruchi Nagpal ◽

Pratibha Taneja ◽

Sakshi Kataria ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Treatment Protocol ◽

Diagnostic Procedures ◽

Present Review ◽

Treatment Modalities ◽

Sufficient Evidence ◽

Obstructive Sleep ◽

Insufficient Knowledge

PURPOSE: The present review was conducted to elaborate Obstructive Sleep Apnea (OSA) and the role of dentist in its diagnoses and management. METHODS: A comprehensive literature search was performed in the electronic databases of PubMed, ScienceDirect and Google scholar. A total of 94 relevant peer reviewed articles were retrieved and 42 were included in the present review. RESULTS: OSA can be fairly diagnosed by dentists while the patient has come for dental check-up. But insufficient knowledge and awareness among dentists about the diagnostic and treatment protocol of this under-diagnosed condition. It has also proven to be one of the underlying cause of many like diseases like cardiovascular problems, diabetes mellitus and hypertension. To the rescue, dental sleep medicine is gaining enormous attention. In the lieu of the above context ‘American Dental Association (ADA)’ has adopted a policy that focuses on outlines various diagnostic procedures and treatment modalities that can be carried out by dentist for management of OSA. CONCLUSION: It can be concluded since there is no sufficient evidence for the prevalence of OSA in developing countries like India, it is needed to create awareness and implement appropriate diagnostic and preventive measures for the same.

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Treatment of Snoring and Obstructive Sleep Apnea Syndrome

Otolaryngology ◽

10.1016/s0194-5998(05)80375-4 ◽

1995 ◽

Vol 112 (5) ◽

pp. P143-P143

Author(s):

Samuel A. Mickelson ◽

B. Tucker Woodson

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep Apnea Syndrome ◽

Diagnostic Tests ◽

Sleep Disordered Breathing ◽

Sleep Apnea Syndrome ◽

Treatment Modalities ◽

Obstructive Sleep ◽

Apnea Syndrome ◽

Abnormal Sleep

Educational objectives: To discuss normal and abnormal sleep patterns, to understand the polysomnogram and the pathophysiology of snoring and obstructive sleep apnea syndrome, and to become familiar with advances in the management of sleep disordered breathing and to understand the various diagnostic tests and surgical and nonsurgical treatment modalities now available and to individualize the approach in surgical treatment.

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Pediatric Obstructive Sleep Apnea: Surgical Techniques beyond Tonsillectomy and Adenoidectomy

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1274 ◽

2016 ◽

Vol 7 (2) ◽

pp. 109-114

Author(s):

Amal Isaiah ◽

Ron B Mitchell

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Surgical Techniques ◽

Standard Of Care ◽

The United States ◽

Treatment Modalities ◽

Childhood Health ◽

Persistent Symptoms ◽

Obstructive Sleep ◽

Controversial Topic

ABSTRACT Sleep disordered breathing (SDB) affects 1 in 10 children in the United States and poses a growing threat to childhood health. Although tonsillectomy and adenoidectomy is considered the standard of care for treatment of pediatric SDB, up to 25% of children present with persistent symptoms after surgery. Success of treatment modalities, such as continuous positive airway pressure (CPAP) is affected by compliance. Management of residual SDB is a complex, and often controversial topic. Here we discuss options for managing childhood SDB that persists after initial management with tonsillectomy. How to cite this article Isaiah A, Mitchell RB. Pediatric Obstructive Sleep Apnea: Surgical Techniques beyond Tonsillectomy and Adenoidectomy. Int J Head Neck Surg 2016;7(2):109-114.

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Obstructive Sleep Apnea Syndrome

Oral and Maxillofacial Surgery for the Clinician ◽

10.1007/978-981-15-1346-6_71 ◽

2021 ◽

pp. 1577-1589

Author(s):

Suresh Menon

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sleep Apnea Syndrome ◽

Upper Airway ◽

Causative Factor ◽

Treatment Modalities ◽

Muscle Physiology ◽

Dilator Muscle ◽

Obstructive Sleep ◽

Apnea Syndrome

AbstractObstructive sleep apnea (OSA) is a condition that occurs due to aberrations in the oropharyngeal anatomy and the upper airway dilator muscle physiology with neurocognitive and cardiovascular sequelae. The mandibular-maxillary complex as the causative factor entails the maxillofacial surgeon to diagnose and treat the case when present, using the different treatment modalities available in the armamentarium.

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