Somnoplasty for simple snoring--a pilot
study.
Sandhu GS, Vatts A, Whinney D, Kotecha B, Croft CB.
The Royal National Throat, Nose and Ear Hospital, London, UK.
A
prospective pilot study was conducted to investigate the efficacy of
radiofrequency thermal ablation (RFTA) of the soft palate to treat
simple snoring. Ten consecutive, consenting patients were recruited
following history, examination, Epworth scoring, sleep nasendoscopy and
full polysomnography. All the patients received two treatments of three
lesional RFTA of the soft palate under local anaesthesia, using the
Somnus S2 generator. Each treatment was separated by 6 weeks. Patients
completed a questionnaire which used visual analogue scales to score
pain during the procedure as well as the postoperative period. Snoring
was also scored on visual analogue scales by both the patient and the
partner. Objective assessment was based on full polysomnography 3
months after the second treatment. Sixty per cent of patients
subjectively reported improvement in snoring. Objectively, only 30%
showed improvement in duration of snoring (38-48% better) with no
change in intensity. There was high patient acceptability of the
procedure.
Snoring How To Stop Products
Celon radiofrequency thermo-ablative
palatoplasty for snoring - a pilot study.
Tatla T, Sandhu G, Croft CB, Kotecha B.
Whipps Cross Hospital, Leytonstone, London, UK.
A
prospective non-randomized study was designed to investigate the
effects of Celon radio-frequency thermo-ablation (RFTA) of the soft
palate in patients with snoring/mild obstructive sleep apnoea. Ten
patients, fulfilling various inclusion/exclusion criteria, underwent
single operator sub-mucosal RFTA palatoplasty as an office procedure.
Two separate procedures six weeks apart involved each patient receiving
six distinct sub-mucosal lesions on each visit. Questionnaires
including visual analogue scales (VAS) were used to evaluate
post-operative pain and subjective snoring (scored by patient/partner).
Polysomnography (PSG) was performed pre-operation and three months
following the second procedure. Using non-parametric statistical
analysis, a significant reduction in VAS snoring was noted from initial
levels to those scored at six and 16 weeks in nine of 10 patients (p =
0.013 and p = 0.007 respectively). (Five of these nine showed a greater
than 50 per cent reduction in score). Objectively, six of 10 patients
had a reduction in the apnoea-hypopnea Index between the two PSGs,
(four of these six showed a greater than 50 per cent reduction)
however, this was not statistically significant. Subjective assessment
of the PSG snoring signal by the senior author showed eight of 10
patients had either a reduced or much reduced signal at four months.
VAS pain confirmed both procedures are well tolerated with minimal
analgesia requirements. Minor complaints of transient mild palatal
swelling, dry throat, catarrh and referred otalgia were noted and one
patient developed mucosal ulceration following both procedures that
healed within three weeks. Swallowing and speech were unaffected. These
results confirm similar findings using the Somnus Unit, although the
Celon device provides additional advantages including inherent safety
in a bipolar electrode tip, auto-stop energy application and reduced
procedure time.
Snoring How To Stop Solution
Associations of symptoms of sleep apnea
with
cardiovascular disease, cognitive impairment, and mortality among older
Japanese-American men.
Foley DJ, Monjan AA, Masaki KH, Enright PL, Quan SF, White LR.
National Institute on Aging, Bethesda, Maryland 20892-9205, USA.
OBJECTIVES:
To examine the association between symptoms of sleep apnea and
prevalent cardiovascular disease, cognitive impairment, and subsequent
3-year mortality. DESIGN: A longitudinal study. SETTING: Participants
lived in the community on Oahu, Hawaii. PARTICIPANTS: A total of 2905
older Japanese-American men participating in the fourth examination of
the Honolulu Heart Program cohort study from 1991-1993, which is the
baseline for the Honolulu-Asia Aging Study of dementia. MEASUREMENTS:
Self-reported snoring, daytime sleepiness, and breathing pauses;
diagnosed cardiovascular disease and dementia; cognitive functioning
and vital status approximately 3 years later. RESULTS: More than 12% of
the participants reported that they often or always snored loudly, and
8% reported being sleepy most of the day. Fewer than 2% reported that
they stop breathing when sleeping, and this was found more frequently
among habitual snorers (7%, P < .001) and those sleepy during the
day (5%, P < .001). The prevalence of habitual snoring declined in
the older age groups, was higher among those with greater Body Mass
Index scores, and was not associated with the reporting of daytime
sleepiness, diagnosis of heart disease, stroke, dementia, or cognitive
impairment. Daytime sleepiness was more prevalent at older ages and was
associated with a higher prevalence of heart disease and with cognitive
impairment and dementia, chronic obstructive pulmonary disease, and
diabetes. Self-reported apnea was associated only with a history of
pneumonia. Three-year mortality was not associated with these symptoms
after adjusting for prevalent heart disease and cognitive impairment.
CONCLUSION: Symptoms of sleep apnea are reported less frequently in
older Japanese-American men. Excessive daytime sleepiness is associated
with poor cognition and dementia, but whether it also is an indicator
for sleep apnea in this age group remains unclear. Epidemiologic
studies of sleep apnea in older adults will require polysomnography to
determine accurately the correlates and consequences of this condition.
|
