Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0037315 (sleep apnea)
 8,000 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This article describes clinical and laboratory technique to use in the fabrication of a prosthesis to prevent sleep apnea in the edentulous patient. The objective of the treatment is to establish a comfortable protrusive and vertical posture of the mandible that prevents or minimizes obstruction of the airway during sleep. During fabrication of the prosthesis, cephalograms are used to assess spatial changes between the base of the tongue and the posterior pharyngeal wall.
 ...
PMID:Fabrication of a prosthesis to prevent sleep apnea in edentulous patients. 218 30

The use of dental appliances in the treatment of patients with snoring and obstructive sleep apnoea is an important treatment modality for those patients not severe enough for continuous positive airway pressure (CPAP) or who cannot tolerate this form of treatment. A mandibular advancement splint has been specifically designed to eliminate snoring and obstructive sleep apnoea. The appliance's design parameters included ease of insertion, comfort, and maximum effectiveness. Customised appliances have been designed for dentate, semi-dentate, and edentulous patients. To date, over 100 appliances have been used with a symptomatic improvement in snoring and well-being in over 80 percent of patients. Dental appliances for the treatment of snoring and obstructive sleep apnoea are simple, cost effective, and reversible.
 ...
PMID:Obstructive sleep apnoea. Part II: Treatment with a customised dental appliance. 909 Feb 59

This report describes the fabrication of a prosthesis to prevent obstructive sleep apnoea in edentulous patients. The objective of treatment in a 62-year-old man was to establish a comfortable protrusive and vertical position of the mandible that minimised hypopharyngeal obstruction nocturnally. An appliance was designed incorporating two concepts in the elimination of obstructive sleep apnoea: mandibular advancement, which maintains hypopharyngeal width nocturnally; and advancement of the tongue with the aid of a device holding the tongue in a protrusive position by vacuum pressure. This combination appliance offers a treatment modality to a large group of otherwise forgotten patients.
 ...
PMID:Treatment of obstructive sleep apnoea in edentulous patients--design of a combination appliance: a case study. 977 49

In patients with congestive heart failure (CHF), sleep disordered breathing (SDB)--including obstructive and central sleep apnoea as well as periodic breathing--is a common condition and is believed to increase the risk of mortality. Treatment of SDB is considered important in the management of CHF. Improvements in SDB have a positive effect on cardiac output, measured with left ventricular ejection fraction (LVEF); on neurohormonal activity, measured as brain natriuretic peptide (BNP); and on the quality of life. Continuous positive airway pressure has been the traditional method used to treat SDB in patients with CHF, but compliance and tolerability are poor. A mandibular advancement device (MAD) is a dental device recommended for the treatment of sleep apnoea, but the method has never been evaluated in patients with CHF. The aims of the present studies were to evaluate the practical use of the MAD for the treatment of SDB in patients with CHF and to test the hypothesis that this intervention increases the dimensions of the pharyngeal airway (PAW), reduces SDB and BNP, and improves LVEF and the quality of life. Patients with mild to moderate CHF and SDB were evaluated using a portable polysomnographic device, lateral radiographs, cardiological and odontological examinations, and quality of life measures prior to and following intervention with an custom-made MAD. At the short-term follow-up 4-6 weeks after habituation with the MAD, the severity of SDB according to the apnoea-hypopnoea index had decreased from 25.1 +/- 9.4 (mean +/- SD) to 14.7 +/- 9.7 (p = 0.003). An increase in the inferior region of the PAW (7 +/- 5 mm) was observed on radiographs (p = 0.0001). However, no correlation between the effect of the MAD on the dimensions of the PAW and its effect on SDB was found. At the 6-month follow-up, the sleep apnoea-related symptoms had decreased by 31% (p = 0.003). Quality of life remained stable. BNP were reduced from 195.8 +/- 180.5 pg/ml to 148.1 +/- 139.9 pg/ml (p = 0.035). LVEF, however, remained unchanged. At the 12-month follow-up, 64 % of the patients were still using the MAD. Three patients withdrew from the study because of discomfort with the MAD. In most patients, MAD treatment had no severe side effect on the signs or symptoms of temporomandibular disorders. However, dental complications were observed. In conclusion, in patients with stable CHF who are experiencing problems with SDB, MAD intervention appears to reduce the severity of SDB, sleep apnoea-related symptoms, and neurohormonal activity. A lower tendency for PAW collapse may explain the effect observed on SDB. The reduction in plasma BNP may indicate decreased cardiac strain as a result of treatment of SDB. The 5-year survival rate, measured from the start of MAD intervention, was higher in the group that used a MAD than in the group that did not use a MAD (p = 0.036). No severe side effects on the stomatognathic system were observed during the intervention, and most patients--edentulous included--tolerated the treatment well. Impaired oral health, including reduced dentition and edentulousness, seemed to limit the use of the MAD in this group of elderly patients, both because of technical difficulties and because of the increased risk of dental complications. However, because the treatment of SDB is important in the management of CHF, the MAD intervention seems to be a valuable method in the treatment arsenal of SDB.
 ...
PMID:Sleep apnoea in patients with stable congestive heart failure an intervention study with a mandibular advancement device. 1563 33

This article describes a snore reduction appliance that can be constructed to advance and hold the mandible in a comfortable prognathic position. The tongue is advanced concomitantly, producing more space in the pharynx while changing the relative positions of the soft palate, posterior tongue, and pharyngeal walls to reduce the incidence of snoring and ameliorate sleep apnea. A dual-laminate appliance, soft inside and hard outside, is vacuformfitted to casts of the maxillary and mandibular teeth and luted in a protrusive relation with cold pressure-cured acrylic. The appliance maintains the mandible and tongue in a protrusive position to open the upper airway, reducing snoring and facilitating breathing. Edentulous patients would require implant-retained appliances for appropriate retention and stability.
 ...
PMID:A dual-laminate snore reduction appliance: a report of four cases. 2059 63