Alberto Labra

Efficacy of Submucosal Sodium Tetradecyl Sulfate in the Soft Palate as a Treatment of the Mild Obstructive Sleep Apnea Syndrome: A Pilot Study

Background. As described by Mair et al. in 2001, snoreplasty, the application of sclerosant agents in the palate is a promising and cheap alternative to treat snoring. We decided to try this kind of therapy for the management of mild sleep apnea. Study Design. Experimental, longitudinal, prospective, nonrandomized, self-controlled pilot study. Methods. 11 patients were included, all of them with a polysomnographic study showing an Apnea-Hypopnea Index (AHI) from 5 to 20, and with a Müller maneuver showing only retropalatal collapse. Results. We found significant decrease in the number of apneas hypopneas and oxygen desaturation as well as in the snoring index (P < 0.05), although no differences were found in the number of arousals. Conclusion. Sclerosant agents might become a relevant part in the treatment of sleep apnea, in very well-selected patients.

Decrease of respiratory events in patients with obstructive sleep apnea-hypopnea syndrome using a mandibular advancement device assessed with split night polysomnography

Introduction Mandibular advancement device (MAD) may represent a feasible choice in the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS), in well selected patients. Objective The aim of this study is to assess the efficacy of MAD in patients with OSAHS, using split night polysomnography (SNP) Method We performed an auto controlled clinical trial to assess the efficacy of MAD in 30 patients with snoring and OSAHS. Clinical evaluation was made every 2 weeks to adjust treatment and observe changes in clinical symptoms. Three-months after placement of the MAD, a SNP was performed, using the MAD in the second half of the night, in order to compare the respiratory results. Results SNP show significant changes with use of MAD (p<0.05) such as: Decrease in Snore index (from 159.95 to 32.46/h) and in Apnea-hypopnea index (AHI, from 22.45 to 4.63/h), increase in oxygen saturation (SaO2, from 89.98% to 91.39%) and somnolence improvement, using the Epworth Sleepiness Scale (from 14.4 to 4.6 points). Conclusion Our data supports that the use of MAD is an alternative in the management of OSAHS, in well selected patients, used in a multidisciplinary fashion, and evaluated using a SNP.

Efficacy of snoreplasty in the soft palate as a treatment of mild OSAS: A pilot study

Problem: As described by Mair et al. in 2001, snoreplasty, the application of sclerosant agents in the palate, is a promising and cheap alternative in the treatment of snoring. We decided to try this kind of therapy for the management of mild sleep apnea. Methods: This was an experimental, longitudinal, prospective, nonrandomized pilot study with autocontrols. We included 10 patients, all of them with a polysomnographic study showing a Respiratory Distress Index (RDI) of 5 to 20, and with the Muller maneuver showing only retropalatal collapse. Results: We found a significant decrease in the number of apneas (P < 0.05), in the oxygen saturation and in the snoring index (P < 0.05 in both), but not in the number of arousals. Conclusion: Sclerosant agents might become a relevant part of the treatment of sleep apnea, in extremely well-selected patients. Significance: If the selection of patients is well done, sclerosant agents may be a cheap and easy way to treat mild sleep apnea, or moderately so if combined with other kind of treatments. Support: None reported.