Continuous positive airway pressure (CPAP) intolerance remains a persistent problem for many obstructive sleep apnea patients. Clinicians and researchers continue to search for other effective treatment modalities given the well-documented sequelae associated with untreated obstructive sleep apnea. A multidisciplinary "Alternatives to CPAP program" (ALT) can facilitate systematic evaluation of non-CPAP therapies appropriate for an individual patient. We review successful strategies and barriers encountered during implementation of an ALT at our institution. Creation of similar programs in private practice and academic settings can help medical, dental, and surgical sleep medicine specialists coordinate evaluation and treatment of CPAP-intolerant patients.
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http://dx.doi.org/10.5664/jcsm.6508 | DOI Listing |
Laryngoscope
September 2024
Departments of Otolaryngology & Sleep Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, U.S.A.
Life (Basel)
August 2024
Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, 2650 Edegem, Belgium.
Obstructive sleep apnea (OSA) is a sleep disorder characterized by repetitive episodes of partial or complete obstruction of the upper airway during sleep. Continuous positive airway pressure (CPAP) is a method used as a first-line treatment for obstructive sleep apnea (OSA). However, intolerance and resistance to CPAP can limit its long-term effectiveness.
View Article and Find Full Text PDFEur Arch Otorhinolaryngol
July 2024
Department of Otolaryngology, Hospital Universitario de Fuenlabrada and Hospital Sanitas La Zarzuela, Universidad Rey Juan Carlos, Madrid, Spain.
Purpose: Drug-induced sleep endoscopy (DISE) is commonly performed in patients suffering obstructive sleep apnea (OSA) with continuous positive airway pressure (CPAP) intolerance. We aimed to evaluate the effects of adding CPAP to DISE to provide understanding of the reason of its failure and better guidance in future therapeutic decisions.
Methods: A retrospective observational descriptive study was conducted on CPAP-intolerant patients with moderate-severe OSA.
Facial Plast Surg
December 2023
Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas.
Obstructive sleep apnea (OSA) and nasal obstruction are common in the general population and frequently treated by otolaryngologists and facial plastic surgeons. Understanding the appropriate pre-, peri-, and postoperative management of OSA patients undergoing functional nasal surgery is important. OSA patients should be appropriately counseled in the preoperative period on their increased anesthetic risk.
View Article and Find Full Text PDFOtolaryngol Head Neck Surg
October 2023
Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Objective: In the last decade, hypoglossal nerve stimulation (HNS) has emerged as a therapeutic alternative for patients with obstructive sleep apnea. The original clinical trial cohorts are entering the phase of expected battery depletion (8-12 years). This study aimed to examine the surgical experience with implantable pulse generator (IPG) replacements and the associated long-term therapy outcomes.
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