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SLEEP APNEA/SNORING
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Sleep Apnea and Snoring

     

Obstructive sleep apnea (OSA) is a widespread disease severely affecting the patient with about 3 to 4% of the German and >12% of the U.S. population being affected. Muscles in the throat collapse during sleep which blocks the airway. As a result the patient frequently stops breathing. This leads to insufficient oxygen supply and as a result the brain signals to the patient to wake up and to restart breathing. Hence, patients are not relaxed but still tired in the morning. Obesity and alcohol consumption increase the disease risk. Consequences are day sleepiness and occurence of secondary diseases such as hypertension, heart attack, stroke or diabetes combined with significantly increased morbidity and mortality.

Further, an especially high risk is imposed on car drivers suffering from OSA. Therefore, successful treatment of sleep apnea and prevention of day sleepiness is a prerequisite for fitness to drive.

Still, only a small precentage of the diseased people are diagnosed but an increasing awareness of the implications of sleep apnea is observed in the public. Diagnosis is performed in a sleep laboratory or ambulant.

The gold standard for efficient therapy of OSA today is CPAP (Continuous Positive Airway Pressure). The patient has to wear a face mask during sleep which is connected to a pump by a tube. The air is actively pumped into the lung so that the airway is kept open by overpressure.

Besides CPAP therapy especially ENT surgical procedures and oral appliances have found broader application. Yet, these are only applicable for mild to medium OSA.

Oral appliances can treat only a tongue base collapse but not the very frequent velopharyngeal collapse.

Surgical treatments frequently provide a limited period of efficacy only. Therefore, such surgical procedures should be used only with special care. Generally, in view of the new non-surgical treatment options those should be preferred.

 

Snoring only to some extent is correlated with OSA. "Harmless" snoring is known as well whereas, nevertheless, this may be medically or socially problematic, too. "Primary" snoring, which also occurs linked to OSA, often may have its roots in the nasopharynx. Strong fluttering of the soft palate and the throat muscles leads to the well known snoring noise.

The cause for primary snoring usually is relaxation of these muscles. Mechanical splinting of the nasopharyngeal muscles and the soft palate with the AlaxoStent may lead to suppression of fluttering.

Snoring may also have other causes. Eventually fluttering of the soft palate and the nasopharyngeal muscles again lead to the snoring noise. Yet, the root of the noise may be different, i.e. a decreased nasal flow due to a constricted nasal passage. Constricted nasal valves or collapsing nasal alars can dramatically reduce the diameter of the nasal airway and thereby strictly reduce the nasal flow volume. Alternatively, swollen turbinates (turbinate hyperplasia) may be the cause. These are cavernous bodies in the nose, covered by a mucosal layer, which serve for heating and moistening of the breathing air. Enduring swelling may lead to a discomfortable feeling of insufficient breathing. Reduced oxygen supply is noxious.

For treatment of these causes the AlaxoLito Nasal Stent for the first time offers an efficient non-surgical therapy option.