31May 2017

OBSTRUCTIVE SLEEP APNEA: PART II. TREATMENT MODALITIES.

Crossref Cited-by Linking logo

  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Obstructive sleep apnea (OSA) can present serious health risks and must be diagnosed by a physician in conjunction with a sleep study. Of nonsurgical treatment alternatives, Nasal continuous positive airway pressure (nCPAP) has been shown to be more effective than oral appliance therapy in improving respiratory disturbances. Common difficulties associated with Continuous positive airway pressure (CPAP) therapy include sense of dryness in the mouth, rhinorrhea, nasal congestion and dryness, mask discomfort, claustrophobia, irritation from device noise, aerophagy, chest discomfort and partners?s intolerance. Therefore many patients are unable to or unwilling to comply with the use of CPAP. This article discusses the various treatment modalities that have been investigated in the management of OSA.

  1. Young T, Palta M, Dempsey J, et al. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993;328:1230-5.
  2. Lynn RC. Obstructive sleep apnea syndrome (OSAS) in children. Diagnostic challenges. Sleep 1996;19:274-7.
  3. PN Chhajed, Trupti P Chhajed, M Tamm, W Strobel. Obstructive Sleep Apnea : Therapies Other Than CPAP. JAPI 2004;52:143-51.
  4. Martin SE, Engleman HM, Deary IJ, et al. The effect of sleep fragmentation on daytime function. Am J Respir Crit Care Med 1996;153:1328-32.
  5. Laube I, Seeger R, Russi EW, et al. Accidents related to sleepiness: Review of medical causes and prevention with special reference to Switzerland. Schweiz Med Wochenschr 1998;128:1487-99.
  6. Sullivan CE, Issa FG, Berthon-Jones M, et al. Reversal of obstructive sleep apnea by continuous positive airway pressure applied through the nares. Lancet 1981;1:862-5.
  7. Guilleminault C, Stoohs R, Clerk A. Daytime somnolence: therapeutic approaches. Neurophysiol Clin 1993;23:23-33.
  8. Pepin JL, Leger P, Veale D, et al. Side effects of nasal continuous positive airway pressure in sleep apnea syndrome. Study of 193 patients in two French sleep centers. Chest 1995;107:375-81.
  9. Fleury B, Rakotonanahary D, Hausser-Hauw C, et al. Objective patient compliance in long-term use of nCPAP. Eur Respir J 1996;9:2356-9.
  10. Engleman HM, Martin SE, Deary IJ, et al. Effect of continuous positive airway pressure treatment on daytime function in sleep apnoea/hypopnoea syndrome. Lancet 1994;343:572-5.
  11. Kribbs NB, Pack AI, Kline LR, et al. Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis 1993;147:887-95.
  12. Strollo PJ, Rogers RM. OBSTRUCTIVE SLEEP APNEA. THE NEW ENGLAND JOURNAL OF MEDICINE 1996;334(2): 99-104.
  13. Grunstein R, Wilcox I, Yang TS, et al. Snoring and sleep apnoea in men: association with central obesity and hypertension. Int J Obes Relat Metab Disord 1993;17:533-40.
  14. Peppard PE, Young T, Palta M, et al. Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA 2000;284:3015-21.
  15. Magalang UJ, Mador MJ. Behavioral and pharmacologic therapy of obstructive sleep apnea. Clin Chest Med 2003;24:343-53.
  16. Oksenberg A, Silverberg DS, Arons E, et al. Positional vs nonpositional obstructive sleep apnea patients: anthropomorphic, nocturnal polysomnographic, and multiple sleep latency test data. Chest 1997;112:629-39.
  17. Cartwright RD. Effect of sleep position on sleep apnea severity. Sleep 1984;7:110-4.
  18. Brown IB, McClean PA, Boucher R, et al. Changes in pharyngeal cross-sectional area with posture and application of continuous positive airway pressure in patients with obstructive sleep apnea. Am Rev Respir Dis 1987;136:628-32.
  19. Jan MA, Marshall I, Douglas NJ. Effect of posture on upper airway dimensions in normal human. Am J Respir Crit Care Med 1994;149:145-8.
  20. Martin SE, Marshall I, Douglas NJ. The effect of posture on airway caliber with the sleep-apnea/hypopnea syndrome. Am J Respir Crit Care Med 1995;152:721-4.
  21. Brownell LG, West P, Sweatman P, et al. Protriptyline in obstructive sleep apnea; a double-blind trial. N Engl J Med 1982;307:1037-42.
  22. Berger AJ, Bayliss DA, Viana F. Modulation of neonatal rat hypoglossal motor neuron excitability by serotonin. Neurosci Lett 1992;143:164-8.
  23. Kubin L, Tojima H, Davies RO, et al. Serotonergic excitatory drive to hypoglossal motoneurons in the decerebrate cat. Neurosci Lett 1992;139:243-8.
  24. Veasey SC, Panckeri KA, Hoffman EA, et al. The effects of serotonin antagonists in an animal model of sleep-disordered breathing. Am J Respir Crit Care Med 1996;153:776-86.
  25. Veasey SC, Fenik P, Panckeri K, et al. The effects of trazodone with L-tryptophan on sleep-disordered breathing in the English bulldog. Am J Respir Crit Care Med 1996;160:1659-67.
  26. Popovic RM, White DP. Upper airway muscle activity in normal women: influence of hormonal status. J Appl Physiol 1998;84:1055-62.
  27. Cistulli PA, Barnes DJ, Grunstein RR, et al. Effect of short-term hormone replacement in the treatment of obstructive sleep apnoea in postmenopausal women. Thorax 1994;49:699-702.
  28. Stewart DA, Grunstein RR, Berthon-Jones M, et al. Androgen blockade does not affect sleep-disordered breathing or chemosensitivity in men with obstructive sleep apnea. Am Rev Respir Dis 1992;146:1389-93.
  29. Rajagopal KR, Abbrecht PH, Jabbari B. Effects of medroxyprogesterone acetate in obstructive sleep apnea. Chest 1986;90:815-21.
  30. Cook WR, Benich JJ, Wooten SA. Indices of severity of obstructive sleep apnea syndrome do not change during medroxyprogesterone acetate therapy. Chest 1989;96:262-66.
  31. Sutton FD, Jr., Zwillich CW, Creagh CE, et al. Progesterone for outpatient treatment of Pickwickian syndrome. Ann Intern Med 1975;83:476-9.
  32. Massumi RA, Winnacker JL. Severe depression of the respiratory center in myxedema. Am J Med 1964;36:876-82.
  33. Rajagopal KR, Abbrecht PH, Derderian SS, et al. Obstructive sleep apnea in hypothyroidism. Ann Intern Med 1984;101:491-4.
  34. Lin CC, Tsan KW, Chen PJ. The relationship between sleep apnea syndrome and hypothyroidism. Chest 1992;102:1663-7.
  35. Whyte KF, Gould GA, Airlie MA, et al. Role of protriptyline and acetazolamide in the sleep apnea/hyponea syndrome. Sleep 1988;11:463-72.
  36. Hudgel DW, Thanakitcharu S. Pharmacologic treatment of sleep-disordered breathing. Am J Respir Crit Care Med 1998;158:691-9.
  37. Weichler U, Herres-Mayer B, Mayer J, et al. Influence of antihypertensive drug therapy on sleep pattern and sleep apnea activity. Cardiology 1991;78:124-30.
  38. Kantola I, Rauhala E, Erkinjuntti M, et al. Sleep disturbances in hypertension: a double-blind study between isradipine and metoprolol. J Cardiovasc Pharamacol 1991;18:841-5.
  39. Garrigue S, Bordier P, Jais P, et al. Benefit of atrial pacing in sleep apnea syndrome. N Engl J Med 2002;346:404-12.
  40. Gislason T, Almqvist M, Boman G et al. Increased CSF opioid activity in sleep apnea syndrome. Regression after sucessful treatment. Chest 1989;96:250-4.
  41. Gothe B, Strohl KP, Levin S, et al. Nicotine: a different approach to treatment of obstructive sleep apnea. Chest 1985;87:11-7.
  42. Davila DG, Hurt RD, Offord KP, et al. Acute effects of transdermal nicotine on sleep architecture, snoring, and sleep-disordered breathing in nonsmokers. Am J Respir Crit Care Med 1994;150:469-74.
  43. Pack AI, Black JE, Schwartz JR, et al. Modafinil as adjunct therapy for daytime sleepiness in obstructive sleep apnea. Am J Respir Crit Care Med 2001;164:1675-81.
  44. Kingshott RN, Vennelle M, Coleman EL, et al. Randomized, double-blind, placebo-controlled crossover trial of modafinil in the treatment of residual excessive daytime sleepiness in the apnea/hypopnea syndrome. Am J Respir Crit Care Med 2001;163:918-23.
  45. Sanders MH, Moore SE, Eveslage J. CPAP via nasal mask: A treatment for occlusive sleep apnea. Chest 1983;83:144-5.
  46. Abbey NC, Cooper KR, Kwentus JA. Benefit of nasal CPAP in obstructive sleep apnea is due to positive pharyngeal pressure. Sleep 1989;12:420-2.
  47. Mortimore IL, Douglas NJ. Palatal muscle EMG response to negative pressure in awake sleep apneic and control subjects. Am J Respir Crit Care Med 1997;156:867-73.
  48. Lin CC. Effect of nasal CPAP on ventilatory drive in normocapnic and hypercapnic patients with obstructive sleep apnea syndrome. Eur Respir J 1994;7:2005-10.
  49. Ryan CF, Lowe AA, Li D, et al. Magnetic resonance imaging of the upper airway in obstructive sleep apnea before and after chronic nasal continuous positive airway pressure therapy. Am Rev Respir Dis 1991;144:939-44.
  50. Ballester E, Badia JR, Hernandez L, et al. Evidence of the effectiveness of continuous positive airway pressure in the treatment of sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 1999;159:495-501.
  51. Redline S, Adams N, Strauss ME, et al. Improvement of mild sleep-disordered breathing with CPAP compared with conservative therapy. Am J Respir Crit Care Med 1998;157:858-65.
  52. Engleman HM, Martin SE, Kingshott RN, et al. Randomized placebo controlled trial of daytime function after continuous positive airway pressure (CPAP) therapy for the sleep apnea/hypopnea syndrome. Thorax 1998;53:341-5.
  53. Engleman HM, Kingshott RN, Wraith PK, et al. Randomized placebo-controlled crossover trial of continuous positive airway pressure for mild sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 1999;159:461-7.
  54. Jenkinson C, Davies RJO, Mullins R, et al. Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnea. Lancet 1999;353:2100-5.
  55. W, Harris CD, Herold D, Shepard Jr JW. The effect of snoring and obstructive sleep apnea on the sleep quality of bed partners: The spousal arousal syndrome. Mayo Clin Proc 1999;74:955-8.
  56. Perker Y, Hedner J, NorumJ, et al. Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: A 7-year follow-up. Am J Respir Crit Care Med 2002;166:159-65.
  57. Doherty LS, Swan V, McNicholas WT. Long-term cardiovascular outcomes of patients with obstructive sleep apnoea not treated with nasal CPAP. Eur Resp J 2002;20(suppl):294.
  58. Jureyda S, Shucard DW. Obstructive Sleep Apnea- An Overview of the Disorder and Its Consequences. Semin Orthod 2004;10:63-72.
  59. Dugal R, Kothavade ME, Musani S. Role of dentist in Mangement of Obstructive Sleep Apnea - An Overview. IJDA 2010;2(2):191-6.
  60. Reeves-Hoche MK, Hudgel DW, Meck R, Witteman R, et al. Continuous versus bilevel positive airway pressure for obstructive sleep apnea. Am J Respir Crit Care Med 1995;151:443-9.
  61. Warunek SP. Oral Appliance Therapy in Sleep Apnea Syndromes: A Review. Semin Orthod 2004;10:73-89.
  62. Machado MA, Juliano L, Taga M, de Carvalho LB, et al. Titratable mandibular repositioner appliances for obstructive sleep apnea syndrome: are they an option?. Sleep Breath. 2007;11(4):225-31.
  63. Barnes M, McEvoy RD, Banks S, Tarquinio N, et al. Efficacy of Positive Airway Pressure and Oral Appliance in Mild to Moderate Obstructive Sleep Apnea. Am J Respir Crit Care Med 2004;170(6):656-64.
  64. Isono S, Tanaka A, Sho Y, Konn A, et al. Advancement of mandible improves velopharyngeal airway patency. J Appl. Physiol 1995;79:2132-8.
  65. Venkat R, Gopichander N, Vasantkumar M. Four novel prosthodontics method for managing upper airway resistance syndrome: An investigative analysis revealing the efficacy of the new nasopharyngeal aperture guard appliance. Indian J Dent Res 2010;21:44-8.
  66. Saee DS, Sarin SP, Pravin S. Obstructive Sleep Apnea: Dental Implications and Treatment Strategies. The Internet Journal of Dental Sciences 2009;7(1).
  67. Heokema A, de Vries F, Heydenrijk K, Stegenga B. Implant-retained oral appliances: a novel treatment for edentulous patients with obstructive sleep apnea-hypopnea syndrome. Clinical Oral Implants Research 2007;10(3):383-7.
  68. Padma A, Ramakrishnan N, Narayan V. Management of obstructive sleep apnea: A dental perspective. Indian J Dent Res 2007;18:201-9.
  69. Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances. American Sleep Disorders Association 1995;18:511-3.
  70. Pancer J, Al Faidi A, Al Faidi M, Hoffstein V. Evaluation of variable mandibular advancement appliances for treatment of snoring and sleep apnea. Chest 1999;116:1511-8.
  71. Kathleen A, Ferguson MD, Cartwright R, Rogers R, et al. Oral Appliances for snoring and Sleep Apnea: A review Sleep. 2006;29(2): 244-62.
  72. Kuhol W, Doll E, Frank MC. Erfolgreiche Behandlung eines pickwick syndrome Dutch eine duwertracheal kannule. Dtsch Med Wochenschr. 1969;94:1286-90.
  73. Ikematsu T. Study of snoring, fourth report: Therapy. J Jpn Otorhinolaryngol 1964;64:434-5.
  74. Sher AE, Schechtman KB, Piccirillo JF. The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Sleep 1996;19:156-77.
  75. Verse T, Pirsig W, Stuck BA, et al. Recent developments in the treatment of obstructive sleep apnea. Am J Respir Med 2003;2:157-68.
  76. Fujita S. Obstructive sleep apnea syndrome: Pathophysiology, upper airway evaluation and surgical treatment. Ear Nose Throat J 1993:72:67-72,75-76.
  77. Moore K. Site-specific versus diffuse treatment/presenting severity of obstructive sleep apnea. Sleep Breath 2000;4:145-6.
  78. Lye KW, Deatherage JR. Surgical Procedures for the Treatment of Obstructive Sleep Apnea. Semin Orthod 2009;15:94-8.
  79. McNamara F, Sullivan CE. Treatment of obstructive sleep apnea syndrome in children. Sleep 2000;23:142-6.
  80. Riley RW, Powell NB, Guilleminault C. Obstructive sleep apnea syndrome: A review of 306 consecutively treated surgical patients. Otolaryngol Head Neck Surg 1993;108:117-25.
  81. Prinsell JR. Maxillomandibular advancement surgery in a site-specific treatment approach for obstructive sleep apnea in 50 consecutive patients. Chest 1999;116:1519-29.
  82. Kamami YV. Outpatient treatment of snoring with CO2 laser:laser assisted UPPP. J Otolaryngol 1994;23:391-4.
  83. Krespi YP, Pearlman SJ, Keidar A. Laser-assisted uvulapalatoplasty for snoring. J Otolaryngol 1994;23:328-34.
  84. Walker RP, Grigg-Damberger MM, Gopalsami C, et al. Laser-assisted uvulopalatoplasty for snoring and obstructive sleep apnea: results in 170 patients. Laryngoscope 1995;105:938-43.
  85. Mickelson SA, Rosenthal L. Midline glossectomy and epiglottidectomy for obstructive sleep apnea syndrome. Laryngoscope 1997;107:614-9.
  86. Walker RP, Grigg-Damberger MM, Gopalsami C. Laser-assisted uvulopalatoplasty for the treatment of mild, moderate, and severe obstructive sleep apnea. Laryngoscope 1999;109:79-85.
  87. Walker RP, Grigg-Damberger MM, Gopalsami C. Uvulopalatopharyngoplasty versus laser-assisted uvuloplatoplasty for the treatment of obstructive sleep apnea. Laryngoscope 1997;107:76-82.
  88. Kuo PC, West RA, Bloomquist DS, et al. The effect of mandibular osteotomy in three patients with hypersomnia sleep apnea. Oral Surg Oral Med Oral Pathol 1979;48:385-92.
  89. Bear SE, Priest JH. Sleep apnea syndrome: correction with surgical advancement of the mandible. J Oral Surg 1980;38:543-9.
  90. Hochban W, Conradt R, Brandenburg U, et al. Surgical maxillofacial treatment of obstructive sleep apnea. Plast Reconstr Surg 1997;99:619-26.
  91. Strohl KP. Diabetes and sleep apnea. Sleep 1996;19(1)0:S225?S228.
  92. Neau JP, Paquereau J, Meurice JC, et al. Stroke and sleep apnoea: Cause or consequence? Sleep Med Rev 2002;6:457-69.
?

[Bobby Joseph Babu, Mahesh CM, Rameshkumar PC, Arun AV, Mahendra S and Balamohan Shetty. (2017); OBSTRUCTIVE SLEEP APNEA: PART II. TREATMENT MODALITIES. Int. J. of Adv. Res. 5 (May). 2074-2084] (ISSN 2320-5407). www.journalijar.com

Bobby Joseph Babu,

DOI:

Article DOI: 10.21474/IJAR01/4352      
DOI URL: https://dx.doi.org/10.21474/IJAR01/4352

Download Full Paper

Download PDF No. of Downloads: 18 | No. of Views: 88