scholarly journals Smart polymer implants as an emerging technology for treating airway collapse in obstructive sleep apnea: a pilot (proof of concept) study

2020 ◽  
Author(s):  
Anders William Sideris ◽  
Gordon Wallace ◽  
Matthew Eugene Lam ◽  
Leon Kitipornchai ◽  
Richard Lewis ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Emerging Technology ◽  
Proof Of Concept ◽  
Smart Polymer ◽  
Concept Study ◽  
Airway Collapse ◽  
Obstructive Sleep ◽  
Polymer Implants

scholarly journals O025 Smart polymer implants as an emerging technology for treating airway collapse in obstructive sleep apnea: proof of concept

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A11-A11
Author(s):  
A Sideris ◽  
G Wallace ◽  
M Lam ◽  
L Kitipornchai ◽  
R Lewis ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Hyoid Bone ◽  
Emerging Technology ◽  
Constrictor Muscle ◽  
Magnetic Forces ◽  
Airway Collapse ◽  
Obstructive Sleep ◽  
Pharyngeal Plexus ◽  
Polymer Implants

Abstract Study objectives To assess the use of a novel magnetic polymer implant in reversing airway collapse and identify potential anatomical targets for airway implant surgery in an in vivo porcine model. Methods Target sites of airway collapse were genioglossus muscle, hyoid bone, and middle constrictor muscle. Magnetic polymer implants were sutured to these sites, and external magnetic forces, through magnets with pull forces rated at 102 kg and 294 kg, were applied at the skin. The resultant airway movement was assessed via nasendoscopy. Pharyngeal plexus branches to the middle constrictor muscle were stimulated at 0.5 mA, 1.0 mA, and 2.0 mA and airway movement assessed via nasendoscopy. Results At the genioglossus muscles, large magnetic forces were required to produce airway movement. At the hyoid bone, anterior movement of the airway was noted when using a 294 kg rated magnet. At the middle constrictor muscle, an anterolateral (or rotatory) pattern of airway movement was noted when using the same magnet. Stimulation of pharyngeal plexus branches to the middle constrictor revealed contraction and increasing rigidity of the lateral walls of the airway as stimulation amplitude increased. The resultant effect was prevention of collapse as opposed to typical airway dilation, a previously unidentified pattern of airway movement. Conclusions Surgically implanted smart polymers are an emerging technology showing promise in the treatment of airway collapse in obstructive sleep apnea. Future research should investigate their biomechanical role as an adjunct to treatment of airway collapse through nerve stimulation.

scholarly journals Much Ado about Sleep: Current Concepts on Mechanisms and Predisposition to Pediatric Obstructive Sleep Apnea

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1032
Author(s):  
Ashley L. Saint-Fleur ◽  
Alexa Christophides ◽  
Prabhavathi Gummalla ◽  
Catherine Kier
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Biomechanical Properties ◽  
Primary Role ◽  
Airway Narrowing ◽  
Airway Collapse ◽  
Upper Airway Collapse ◽  
Obstructive Sleep ◽  
Review Current

Obstructive Sleep Apnea (OSA) is a form of sleep-disordered breathing characterized by upper airway collapse during sleep resulting in recurring arousals and desaturations. However, many aspects of this syndrome in children remain unclear. Understanding underlying pathogenic mechanisms of OSA is critical for the development of therapeutic strategies. In this article, we review current concepts surrounding the mechanism, pathogenesis, and predisposing factors of pediatric OSA. Specifically, we discuss the biomechanical properties of the upper airway that contribute to its primary role in OSA pathogenesis and examine the anatomical and neuromuscular factors that predispose to upper airway narrowing and collapsibility.

Induction of airway collapse with subatmospheric pressure in awake patients with sleep apnea

1984 ◽  
Vol 57 (1) ◽  
pp. 140-146 ◽  
Author(s):  
P. M. Suratt ◽  
S. C. Wilhoit ◽  
K. Cooper
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Obstruction ◽  
Supine Position ◽  
Face Mask ◽  
Subatmospheric Pressure ◽  
Pharyngeal Airway ◽  
Airway Collapse ◽  
Obstructive Sleep ◽  
Obese Control

To determine whether the pharyngeal airway is abnormal in awake patients with obstructive sleep apnea (OSA), we measured the ability of the pharyngeal airway to resist collapse from subatmospheric pressure applied to the nose in awake subjects, 12 with OSA and 12 controls. Subatmospheric pressure was applied to subjects placed in the supine position through a tightly fitting face mask. We measured airflow at the mask as well as mask, pharyngeal, and esophageal pressures. Ten patients developed airway obstruction when subatmospheric pressures between 17 and 40 cmH2O were applied. Obstruction did not occur in two patients with the least OSA. Obstruction did not occur in 10 controls; one obese control subject developed partial airway obstruction when -52 cmH2O was applied as did another with -41 cmH2O. We conclude that patients with significant OSA have an abnormal airway while they are awake andthat application of subatmospheric pressure may be a useful screening test to detect OSA.

An Adaptive Treatment to Improve Positive Airway Pressure (PAP) Adherence in Patients With Obstructive Sleep Apnea: A Proof of Concept Trial

2016 ◽  
Vol 15 (5) ◽  
pp. 345-360 ◽  
Author(s):  
Jamie A. Cvengros ◽  
Vivian M. Rodríguez ◽  
Sarah Snyder ◽  
Megan M. Hood ◽  
Megan Crawford ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Proof Of Concept ◽  
Adaptive Treatment ◽  
Obstructive Sleep

268 Smart polymer implants as an emerging technology for treating airway collapse in OSA: a proof of concept study

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A107-A108
Author(s):  
Anders Sideris ◽  
Gordon Wallace ◽  
Matthew Lam ◽  
Leon Kitipornchai ◽  
Richard Lewis ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Hyoid Bone ◽  
Porcine Model ◽  
Emerging Technology ◽  
Smart Polymers ◽  
Magnetic Forces ◽  
Airway Collapse ◽  
Obstructive Sleep ◽  
Pharyngeal Plexus

Abstract Introduction Implantable 3D printed ‘smart’ polymers are an emerging technology with potential applications in treating collapse in adult obstructive sleep apnea through mechanical airway manipulation. There is a paucity of devices that are commercially available or in research and development stage. Limited studies have investigated the use of implantable smart polymers in reversing the collapsibility of the pharyngeal airway by creating counter forces during sleep. This paper describes an application of implantable magnetic polymer technology in an in-vivo porcine model. Study Objectives: To assess the use of a novel magnetic polymer implant in reversing airway collapse and identifying potential anatomical targets for airway implant surgery in an in-vivo porcine model. Methods Target sites of airway collapse were genioglossus muscle, hyoid bone and middle constrictor. Magnetic polymer implants were sutured to these sites and external magnetic forces, through magnets with pull forces rated at 102kg and 294kg, were applied at the skin. The resultant airway movement was assessed via nasendoscopy. Pharyngeal plexus branches to the middle constrictor muscle were stimulated at 0.5mA, 1.0mA and 2.0mA and airway movement assessed via nasendoscopy. Results At the genioglossus muscles large magnetic forces were required to produce airway movement. At the hyoid bone, anterior movement of the airway was noted when using a 294kg rated magnet. At the middle constrictor muscle, an anterolateral (or rotatory) pattern of airway movement was noted when using the same magnet. Stimulation of pharyngeal plexus branches to the middle constrictor revealed contraction and increasing rigidity of the lateral walls of the airway as stimulation amplitude increased. The resultant effect was prevention of collapse, a previously unidentified pattern of airway movement. Conclusion Surgically implanted smart polymers are an emerging technology showing promise in the treatment of airway collapse in obstructive sleep apnea. Future research should investigate their biomechanical role as an adjunct to treatment of airway collapse through nerve stimulation. Support (if any) Garnett-Passe and Rodney Williams Memorial Foundation, Conjoint Grant, 2016-18.

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