scholarly journals Diagnosis and treatment of obstructive sleep apnea

Author(s):  
Fahad Saleh Bin Salamah ◽  
Hiba Mohammed Al Alfayez ◽  
Raghad Taha Melibary

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.

2020 ◽  
Vol 13 (3) ◽  
pp. 215-224 ◽  
Author(s):  
Stanley Yung-Chuan Liu ◽  
Robert Wayne Riley ◽  
Myeong Sang Yu

Sleep surgery is part of a continuum of care for obstructive sleep apnea (OSA) that involves medical, pharmacologic, and behavioral therapy. Upper airway surgery for OSA can significantly improve stability by way of modulating the critical negative closing pressure. This is the same mechanism of action as positive airway pressure or oral appliance therapy. The updated surgical algorithm in this review adds precision in three areas: patient selection, identification of previously unaddressed anatomic phenotypes with associated treatment modality, and improved techniques of previously established procedures. While the original Riley and Powell phase 1 and 2 approach to sleep surgery has focused on individual surgical success rate, this algorithm strives for an overall treatment success with multi-modal and patient-centric treatments.


2021 ◽  
Vol 11 (41) ◽  
pp. 30-33
Author(s):  
Erdem Atalay Cetinkaya

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.


Author(s):  
Suresh Menon

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.


1986 ◽  
Vol 147 (6) ◽  
pp. 1330-1331
Author(s):  
I Rubinstein ◽  
N Zamel ◽  
V Hoffstein

ORL ◽  
2021 ◽  
pp. 1-8
Author(s):  
Lifeng Li ◽  
Demin Han ◽  
Hongrui Zang ◽  
Nyall R. London

<b><i>Objective:</i></b> The purpose of this study was to evaluate the effects of nasal surgery on airflow characteristics in patients with obstructive sleep apnea (OSA) by comparing the alterations of airflow characteristics within the nasal and palatopharyngeal cavities. <b><i>Methods:</i></b> Thirty patients with OSA and nasal obstruction who underwent nasal surgery were enrolled. A pre- and postoperative 3-dimensional model was constructed, and alterations of airflow characteristics were assessed using the method of computational fluid dynamics. The other subjective and objective clinical indices were also assessed. <b><i>Results:</i></b> By comparison with the preoperative value, all postoperative subjective symptoms statistically improved (<i>p</i> &#x3c; 0.05), while the Apnea-Hypopnea Index (AHI) changed little (<i>p</i> = 0.492); the postoperative airflow velocity and pressure in both nasal and palatopharyngeal cavities, nasal and palatopharyngeal pressure differences, and total upper airway resistance statistically decreased (all <i>p</i> &#x3c; 0.01). A significant difference was derived for correlation between the alteration of simulation metrics with subjective improvements (<i>p</i> &#x3c; 0.05), except with the AHI (<i>p</i> &#x3e; 0.05). <b><i>Conclusion:</i></b> Nasal surgery can decrease the total resistance of the upper airway and increase the nasal airflow volume and subjective sleep quality in patients with OSA and nasal obstruction. The altered airflow characteristics might contribute to the postoperative reduction of pharyngeal collapse in a subset of OSA patients.


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