New oral appliance could help manage sleep apnoea
HIROSHIMA, Japan: Researchers have recently developed a novel treatment to improve the quality of sleep for patients who suffer from mild to moderate obstructive sleep apnoea (OSA). Using 3-D imaging of the airways with the patients supine to simulate sleeping conditions, the study confirmed that the treatment is effective at opening the airways and warrants further collaboration between dentists and doctors in the treatment of sleep apnoea.
The treatment was developed by researchers from the Department of Orthodontics at Hiroshima University Hospital. The participants included eight men and five women who were diagnosed with mild to moderate OSA and underwent mandibular advancement appliance (MAA) therapy. The researchers used multi-slice computed tomography in order to measure the regional effects of the appliance on the upper airway.
“This is like when you have to use glasses. You have to wear them every time you want to see properly so [patients] have to wear this appliance every time [they] want to sleep better,” said study co-author Dr Hiroshi Ueda, an associate professor in the Graduate School of Biomedical and Health Sciences at Hiroshima University.
Previous research typically measured patients standing up, a technique that does not simulate sleeping conditions. The current study measured the change in airway space of patients lying flat. It demonstrated that the proportional size of the soft-tissue volume, that is, the soft palate and tongue in the oro-hypopharyngeal region, significantly decreased when the patient was wearing an MAA. This forward displacement of the soft tissue thereby increased the retro-glossal airway space, except the nasopharynx, three-dimensionally and therefore allowed for easier breathing.
According to the researchers, further investigations that focus on 3-D airway enlargement analysis of various sites affected by MAA therapy are required in a larger number of patients with OSA. This would help scientists understand the pathogenesis of OSA and the clinical applicability of MAA fully.
The study, titled “Multislice computed tomography assessment of airway patency changes associated with mandibular advancement appliance therapy in supine patients with obstructive sleep apnea”, was published online on 3 March 2019 in Sleep Disorders.