Innovative treatments for adults with obstructive sleep apnea

Terri E Weaver,1,2 Michael W Calik,1,2 Sarah S Farabi,1,2 Anne M Fink,1,2 Maria T Galang-Boquiren,2,3 Mary C Kapella,1,2 Bharati Prasad,2,4 David W Carley1,21Biobehavioral Health Science Department, College of Nursing, University of Illinois at Chicago; 2Center for Narcolepsy, Sleep and Health, Uni...

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Autores principales:	Weaver TE, Calik MW, Farabi SS, Fink AM, Galang-Boquiren MT, Kapella MC, Prasad B, Carley DW
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/743db9e49271407eab5ec5aab0ec12ea
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spelling	oai:doaj.org-article:743db9e49271407eab5ec5aab0ec12ea2021-12-02T02:28:37ZInnovative treatments for adults with obstructive sleep apnea1179-1608https://doaj.org/article/743db9e49271407eab5ec5aab0ec12ea2014-11-01T00:00:00Zhttp://www.dovepress.com/innovative-treatments-for-adults-with-obstructive-sleep-apnea-peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608 Terri E Weaver,1,2 Michael W Calik,1,2 Sarah S Farabi,1,2 Anne M Fink,1,2 Maria T Galang-Boquiren,2,3 Mary C Kapella,1,2 Bharati Prasad,2,4 David W Carley1,21Biobehavioral Health Science Department, College of Nursing, University of Illinois at Chicago; 2Center for Narcolepsy, Sleep and Health, University of Illinois at Chicago College of Nursing, 3Department of Orthodontics, University of Illinois at Chicago College of Dentistry, 4Sleep Center, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL, USAAbstract: Obstructive sleep apnea (OSA) affects one in five adult males and is associated with significant comorbidity, cognitive impairment, excessive daytime sleepiness, and reduced quality of life. For over 25 years, the primary treatment has been continuous positive airway pressure, which introduces a column of air that serves as a pneumatic splint for the upper airway, preventing the airway collapse that is the physiologic definition of this syndrome. However, issues with patient tolerance and unacceptable levels of treatment adherence motivated the exploration of other potential treatments. With greater understanding of the physiologic mechanisms associated with OSA, novel interventions have emerged in the last 5 years. The purpose of this article is to describe new treatments for OSA and associated complex sleep apnea. New approaches to complex sleep apnea have included adaptive servoventilation. There is increased literature on the contribution of behavioral interventions to improve adherence with continuous positive airway pressure that have proven quite effective. New non-surgical treatments include oral pressure devices, improved mandibular advancement devices, nasal expiratory positive airway pressure, and newer approaches to positional therapy. Recent innovations in surgical interventions have included laser-assisted uvulopalatoplasty, radiofrequency ablation, palatal implants, and electrical stimulation of the upper airway muscles. No drugs have been approved to treat OSA, but potential drug therapies have centered on increasing ventilatory drive, altering the arousal threshold, modifying loop gain (a dimensionless value quantifying the stability of the ventilatory control system), or preventing airway collapse by affecting the surface tension. An emerging approach is the application of cannabinoids to increase upper airway tone.Keywords: obstructive sleep apnea, innovative treatment, continuous positive airway pressure, oral appliance, nerve stimulation Weaver TECalik MWFarabi SSFink AMGalang-Boquiren MTKapella MCPrasad BCarley DWDove Medical PressarticlePsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol 2014, Iss default, Pp 137-147 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Weaver TE Calik MW Farabi SS Fink AM Galang-Boquiren MT Kapella MC Prasad B Carley DW Innovative treatments for adults with obstructive sleep apnea
description	Terri E Weaver,1,2 Michael W Calik,1,2 Sarah S Farabi,1,2 Anne M Fink,1,2 Maria T Galang-Boquiren,2,3 Mary C Kapella,1,2 Bharati Prasad,2,4 David W Carley1,21Biobehavioral Health Science Department, College of Nursing, University of Illinois at Chicago; 2Center for Narcolepsy, Sleep and Health, University of Illinois at Chicago College of Nursing, 3Department of Orthodontics, University of Illinois at Chicago College of Dentistry, 4Sleep Center, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL, USAAbstract: Obstructive sleep apnea (OSA) affects one in five adult males and is associated with significant comorbidity, cognitive impairment, excessive daytime sleepiness, and reduced quality of life. For over 25 years, the primary treatment has been continuous positive airway pressure, which introduces a column of air that serves as a pneumatic splint for the upper airway, preventing the airway collapse that is the physiologic definition of this syndrome. However, issues with patient tolerance and unacceptable levels of treatment adherence motivated the exploration of other potential treatments. With greater understanding of the physiologic mechanisms associated with OSA, novel interventions have emerged in the last 5 years. The purpose of this article is to describe new treatments for OSA and associated complex sleep apnea. New approaches to complex sleep apnea have included adaptive servoventilation. There is increased literature on the contribution of behavioral interventions to improve adherence with continuous positive airway pressure that have proven quite effective. New non-surgical treatments include oral pressure devices, improved mandibular advancement devices, nasal expiratory positive airway pressure, and newer approaches to positional therapy. Recent innovations in surgical interventions have included laser-assisted uvulopalatoplasty, radiofrequency ablation, palatal implants, and electrical stimulation of the upper airway muscles. No drugs have been approved to treat OSA, but potential drug therapies have centered on increasing ventilatory drive, altering the arousal threshold, modifying loop gain (a dimensionless value quantifying the stability of the ventilatory control system), or preventing airway collapse by affecting the surface tension. An emerging approach is the application of cannabinoids to increase upper airway tone.Keywords: obstructive sleep apnea, innovative treatment, continuous positive airway pressure, oral appliance, nerve stimulation
format	article
author	Weaver TE Calik MW Farabi SS Fink AM Galang-Boquiren MT Kapella MC Prasad B Carley DW
author_facet	Weaver TE Calik MW Farabi SS Fink AM Galang-Boquiren MT Kapella MC Prasad B Carley DW
author_sort	Weaver TE
title	Innovative treatments for adults with obstructive sleep apnea
title_short	Innovative treatments for adults with obstructive sleep apnea
title_full	Innovative treatments for adults with obstructive sleep apnea
title_fullStr	Innovative treatments for adults with obstructive sleep apnea
title_full_unstemmed	Innovative treatments for adults with obstructive sleep apnea
title_sort	innovative treatments for adults with obstructive sleep apnea
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/743db9e49271407eab5ec5aab0ec12ea
work_keys_str_mv	AT weaverte innovativetreatmentsforadultswithobstructivesleepapnea AT calikmw innovativetreatmentsforadultswithobstructivesleepapnea AT farabiss innovativetreatmentsforadultswithobstructivesleepapnea AT finkam innovativetreatmentsforadultswithobstructivesleepapnea AT galangboquirenmt innovativetreatmentsforadultswithobstructivesleepapnea AT kapellamc innovativetreatmentsforadultswithobstructivesleepapnea AT prasadb innovativetreatmentsforadultswithobstructivesleepapnea AT carleydw innovativetreatmentsforadultswithobstructivesleepapnea
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Innovative treatments for adults with obstructive sleep apnea

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