Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
-
Comparative Study
Comparison of adjustable and fixed oral appliances for the treatment of obstructive sleep apnea.
To compare the efficacy of adjustable and fixed oral appliances for the treatment of OSA. ⋯ Adjustable devices produced greater reductions in obstructive events and were more likely to provide successful therapy, especially in moderate-severe OSA. Fixed appliances were effective in mild disease, but were less successful in those with higher AHIs. Given these findings, the baseline AHI should be considered when selecting the type of oral appliance.
-
Given the pathogenesis of obstructive sleep apnea (OSA), anesthesiologists may be in a unique position to rapidly identify patients who are at risk for undiagnosed OSA in the perioperative period. Identification is the first step in prompt diagnosis and potential prevention of OSA related comorbidities. Patients who exhibit unanticipated difficult mask ventilation (DMV) during induction of general anesthesia may be at risk of having undiagnosed OSA. ⋯ In this study, difficult mask ventilation was predictive of undiagnosed OSA. Anesthesiologists may be in a unique position to identify patients at risk for OSA and prevention of related comorbidities.
-
Various models and questionnaires have been developed for screening specific populations for obstructive sleep apnea (OSA) as defined by the apnea/hypopnea index (AHI); however, almost every method is based upon dichotomizing a population, and none function ideally. We evaluated the possibility of using the STOP-Bang model (SBM) to classify severity of OSA into 4 categories ranging from none to severe. ⋯ The STOP-Bang model may be useful to categorize OSA severity, triage patients for diagnostic evaluation or exclude from harm.
-
Randomized Controlled Trial Comparative Study
Accurate position monitoring and improved supine-dependent obstructive sleep apnea with a new position recording and supine avoidance device.
Approximately 30% of obstructive sleep apnea (OSA) patients have supine-predominant OSA, and simply avoiding supine sleep should normalise respiratory disturbance event rates. However, traditional supine-avoidance therapies are inherently uncomfortable, and treatment adherence is poor and difficult to monitor objectively. This study evaluated the efficacy of a novel, potentially more acceptable position monitor and supine-avoidance device for managing supine-predominant OSA and snoring. ⋯ This new position monitoring and supine alarm device records sleep position accurately and improves OSA but not snoring in patients with supine-predominant OSA.
-
To validate the ApneaLINK (AL) as an accurate tool for determining the presence of obstructive sleep apnea (OSA) in an at-risk sleep clinic population in a home test environment. ⋯ The AL home test is an accurate alternative to PSG in sleep clinic populations at risk for moderate and severe OSA.