Obstructive Sleep Apnea Treated by Independently Adjusted Inspiratory and Expiratory Positive Airway Pressures via Nasal Mask

CHEST Journal ◽  
1990 ◽  
Vol 98 (2) ◽  
pp. 317-324 ◽  
Author(s):  
Mark H. Sanders ◽  
Nancy Kern
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nasal Mask ◽  
Airway Pressures ◽  
Obstructive Sleep

scholarly journals CPAP - The choice of the mask does matter

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Bordas-Martinez J ◽  
◽  
Salord N ◽  
Calvo M ◽  
Monasterio C ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Tertiary Care ◽  
Nasal Mask ◽  
Nasal Cpap ◽  
Obstructive Sleep ◽  
Cpap Compliance ◽  
Oronasal Mask ◽  
Keywords Obstructive Sleep Apnea

We present a case of a patient with uncorrected Obstructive Sleep Apnea (OSA) despite good CPAP compliance with an oronasal mask who was referred to our tertiary care multidisciplinary sleep unit. We present here our systematic and comprehensive re-evaluation of the case, accompanied by an image of the polysomnography recordings that exemplify each step in the process, which concludes with a change to nasal CPAP and a transition to BPAP treatment. Keywords: obstructive sleep apnea; CPAP; BPAP; oronasal mask; nasal mask.

scholarly journals Diabetics with Obstructive Sleep Apnea need Higher Positive Airway Pressures

2017 ◽  
Vol 12 (3) ◽  
pp. 39-43
Author(s):  
Ashalatha Radhakrishnan ◽  
Sapna E Sreedharan ◽  
Pragati Agrawal ◽  
Chembakode A Anees ◽  
MJ Pradeep ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Pressures ◽  
Obstructive Sleep

Upper airway pressure-flow relationships in obstructive sleep apnea

1988 ◽  
Vol 64 (2) ◽  
pp. 789-795 ◽  
Author(s):  
P. L. Smith ◽  
R. A. Wise ◽  
A. R. Gold ◽  
A. R. Schwartz ◽  
S. Permutt
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Face Mask ◽  
Esophageal Pressure ◽  
Positive Pressure ◽  
Nasal Mask ◽  
Pressure Flow ◽  
Obstructive Sleep ◽  
Full Face

We examined the pressure-flow relationships in patients with obstructive sleep apnea utilizing the concepts of a Starling resistor. In six patients with obstructive sleep apnea, we applied incremental levels of positive pressure through a nasal mask during non-rapid-eye-movement sleep. A positive critical opening pressure (Pcrit) of 3.3 +/- 3.3 (SD) cmH2O was demonstrated. As nasal pressure was raised above Pcrit, inspiratory airflow increased in proportion to the level of positive pressure applied until apneas were abolished (P less than 0.01). However, at pressures greater than Pcrit, esophageal pressures either did not correlate or correlated inversely with inspiratory airflow provided that esophageal pressure was less than Pcrit. When pressure was applied to a full face mask, inspiratory airflow did not occur and Pcrit could not be obtained at pressures well above Pcrit demonstrated with the nasal mask. These results are consistent with the view that the upper airway functions as a Starling resistor with a collapsible segment in the oropharynx. These findings offer a unifying construct for the association of sleep apnea, periodic hypopnea, and snoring.

Treating Velopharyngeal Inadequacy Using Bilateral Buccal Flap Revision Palatoplasty

2019 ◽  
Vol 4 (5) ◽  
pp. 878-892
Author(s):  
Joseph A. Napoli ◽  
Linda D. Vallino
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
A Priori ◽  
Sufficient Evidence ◽  
Obstructive Sleep ◽  
Before And After ◽  
Buccal Flap

Purpose The 2 most commonly used operations to treat velopharyngeal inadequacy (VPI) are superiorly based pharyngeal flap and sphincter pharyngoplasty, both of which may result in hyponasal speech and airway obstruction. The purpose of this article is to (a) describe the bilateral buccal flap revision palatoplasty (BBFRP) as an alternative technique to manage VPI while minimizing these risks and (b) conduct a systematic review of the evidence of BBFRP on speech and other clinical outcomes. A report comparing the speech of a child with hypernasality before and after BBFRP is presented. Method A review of databases was conducted for studies of buccal flaps to treat VPI. Using the principles of a systematic review, the articles were read, and data were abstracted for study characteristics that were developed a priori. With respect to the case report, speech and instrumental data from a child with repaired cleft lip and palate and hypernasal speech were collected and analyzed before and after surgery. Results Eight articles were included in the analysis. The results were positive, and the evidence is in favor of BBFRP in improving velopharyngeal function, while minimizing the risk of hyponasal speech and obstructive sleep apnea. Before surgery, the child's speech was characterized by moderate hypernasality, and after surgery, it was judged to be within normal limits. Conclusion Based on clinical experience and results from the systematic review, there is sufficient evidence that the buccal flap is effective in improving resonance and minimizing obstructive sleep apnea. We recommend BBFRP as another approach in selected patients to manage VPI. Supplemental Material https://doi.org/10.23641/asha.9919352

Sign in / Sign up

Export Citation Format

Share Document