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Ssegonja R, Ljunggren M, Sampaio F, Tegelmo T, Theorell-Haglöw J. Economic evaluation of telemonitoring as a follow-up approach for patients with obstructive sleep apnea syndrome starting treatment with continuous positive airway pressure. J Sleep Res 2024; 33:e13968. [PMID: 37337981 DOI: 10.1111/jsr.13968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/15/2023] [Accepted: 06/05/2023] [Indexed: 06/21/2023]
Abstract
Telemonitoring of obstructive sleep apnea patients is increasingly being adopted though its cost-effectiveness evidence base is scanty. This study investigated whether telemonitoring is a cost-effective strategy compared with the standard follow-up in patients with obstructive sleep apnea who are starting continuous positive airway pressure treatment. In total, 167 obstructive sleep apnea patients were randomised into telemonitoring (n = 79) or standard follow-up (n = 88), initiated continuous positive airway pressure treatment, and were followed up for 6 months. The frequencies of healthcare contacts, related costs (in USD 2021 prices), treatment effect and compliance were compared between the follow-up approaches using generalised linear models. The cost effectiveness analysis was conducted from a healthcare perspective and the results presented as cost per avoided extra clinic visit. Additionally, patient satisfaction between the two approaches was explored. The analysis showed no baseline differences. At follow-up, there was no significant difference in treatment compliance, and the mean residual apnea-hypoapnea index. There was no difference in total visits, adjusted incidence rate ratio 0.87 (0.72-1.06). Participants in the telemonitoring arm made eight times more telephone visits, 8.10 (5.04-13.84), and about 73% fewer physical healthcare visits 0.27 (0.20-0.36). This translated into significantly lower total costs for the telemonitoring approach compared with standard follow-up, -192 USD (-346 to -41). The form of follow-up seemed to have no impact on the extent of patient satisfaction. These results demonstrate the telemonitoring of patients with obstructive sleep apnea initiating continuous positive airway pressure treatment as a cost saving strategy and can be argued as a potential worthy investment.
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Affiliation(s)
- Richard Ssegonja
- Department of Medical Sciences, Respiratory, Allergy- and Sleep Medicine Research Unit, Uppsala University, Uppsala, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Mirjam Ljunggren
- Department of Medical Sciences, Respiratory, Allergy- and Sleep Medicine Research Unit, Uppsala University, Uppsala, Sweden
| | - Filipa Sampaio
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Tove Tegelmo
- Department of Medical Sciences, Respiratory, Allergy- and Sleep Medicine Research Unit, Uppsala University, Uppsala, Sweden
| | - Jenny Theorell-Haglöw
- Department of Medical Sciences, Respiratory, Allergy- and Sleep Medicine Research Unit, Uppsala University, Uppsala, Sweden
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Pizzi JF, Carrada CF, Zeferino MVDS, Doriguêtto PVT, Abreu LG, Scalioni FAR, Devito KL, Ribeiro RA. Overweight/obesity and dental caries in Brazilian children and adolescents: a systematic review and meta-analysis. Braz Oral Res 2024; 38:e015. [PMID: 38477801 DOI: 10.1590/1807-3107bor-2024.vol38.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 09/13/2023] [Indexed: 03/14/2024] Open
Abstract
This review aimed to assess the association between overweight/obesity and dental caries in Brazilian children/adolescents. Searches were performed in the Web of Science, Scopus, Cochrane, PubMed, Embase and SciELO, Lilacs and Open Grey literature databases up to June 2022. The Joanna Briggs Institute checklist for analytical cross-sectional studies, the checklist for cohort studies, and the checklist for case-control studies were used. A total of 41 publications were included, and 15 meta-analyses were performed. The authors analyzed the differences in weighted mean difference (MD) and odds ratios (OR), and their corresponding confidence intervals (CI) (95%) for dental caries among eutrophic and obese and/or overweight children/adolescents. Meta-analyses showed that there was no association between overweight and/or obesity and dental caries in Brazilian children/adolescents for most anthropometric reference curves using BMI (Body Mass Index). A greater experience of dental caries was associated with well-nourished adolescents in permanent dentition, compared with obese individuals in the same dentition, as classified by the CDC 2000 curve (OR = 2.53, 95% CI;1.49-4.29; p = 0.0006; I2 = 0%) in dichotomous outcome studies, and (MD = 0.61, 95%CI: 0.08-1.15; p = 0.02; I2 = 0%) in continuous studies. The strength of the evidence of the results was classified as very low, low or moderate. It was concluded that there is no association between overweight and/or obesity and dental caries in Brazilian children/adolescents for most anthropometric reference curves using BMI. A greater experience of dental caries was associated with well-nourished adolescents in permanent dentition, compared with obese individuals in the same dentition, as classified by the CDC 2000 curve.
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Affiliation(s)
- Julia Faria Pizzi
- Universidade Federal de Juiz de Fora - UFJF, School of Dentistry, Juiz de Fora, MG, Brazil
| | - Camila Faria Carrada
- Faculdade de Ciências Médicas e da Saúde - Suprema, School of Dentistry, Department of Paediatric Dentistry, Juiz de Fora, MG, Brazil
| | | | | | - Lucas Guimarães Abreu
- Universidade Federal de Minas Gerais - UFMG, Schoool of Dentistry, Department of Oral Health for Children and Adolescents, Belo Horizonte, MG, Brazil
| | - Flávia Almeida Ribeiro Scalioni
- Universidade Federal de Juiz de Fora - UFJF, School of Dentistry, Department of Social and Paediatric Dentistry; Juiz de Fora, MG, Brazil
| | - Karina Lopes Devito
- Universidade Federal de Juiz de Fora - UFJF, School of Dentristry, Department of Dental Clinic, Juiz de Fora, MG, Brazil
| | - Rosangela Almeida Ribeiro
- Universidade Federal de Juiz de Fora - UFJF, School of Dentistry, Department of Social and Paediatric Dentistry; Juiz de Fora, MG, Brazil
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Correia S, Gonzalez M, Deger M, Pitts P. The Value of Implementing a Digital Approach in the Obstructive Sleep Apnoea Patient Pathway: A Spanish Example. OPEN RESPIRATORY ARCHIVES 2024; 6:100289. [PMID: 38225949 PMCID: PMC10788272 DOI: 10.1016/j.opresp.2023.100289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/02/2023] [Indexed: 01/17/2024] Open
Abstract
Introduction Continuous positive airway pressure (CPAP) is the gold standard therapy for obstructive sleep apnoea (OSA). However, non-adherence is common and costly. The COVID-19 pandemic required the use of novel solutions to ensure service provision and quality of care. This retrospective analysis determined the impact and value of a digital versus standard pathway for the management of OSA in Spain. Methods A time-driven activity-based costing approach was applied to OSA management over 1 year using a standard or digital pathway. The standard pathway included face-to-face appointments at the time of diagnosis, then after 1-3 months and every 6 months thereafter. The digital pathway had fewer face-to-face appointments and utilised telemonitoring. A cost analysis was performed to determine the per-patient cost per healthcare professional (HCP) for a digital pathway for therapy implementation and follow-up compared with the standard pathway. Results Compared with the standard pathway, the digital pathway decreased the waiting list time from 18 to 2 months, the overall pathway time from 12 to 6 months, HCP cost per patient from €95 to €85, and number of hospital appointments per patient from 6 to 3.1. Furthermore, CPAP device usage improved from 5.7 to 6.3 h/night and the proportion of individuals defined as adherent increased from 79% to 91%. Conclusions Implementation of digital processes using available technology reduced HCP time and costs, and improved adherence to CPAP in people with OSA. Greater utilisation of a digital pathway could improve access to therapy, allow personalised patient management, and facilitate better clinical outcomes.
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Affiliation(s)
| | - Monica Gonzalez
- Sleep and Ventilation Unit, Pneumology Department, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Marqués de Valdecilla, University of Cantabria, Santander, Spain
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Russell M, Baldwin CM, Quan SF. Exploring Sleep in Caregivers of Children with Autism Spectrum Disorder (ASD) and the Relationship to Health-Related Quality of Life (HRQoL) and Family Quality of Life (FQoL). MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2132. [PMID: 38138235 PMCID: PMC10744649 DOI: 10.3390/medicina59122132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/21/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: To investigate (1) the prevalence of sleep disorder symptoms in caregivers of children with autism spectrum disorder (ASD) and (2) the relationships between caregiver sleep problems and their health-related quality of life and family quality of life. Materials and Methods: Descriptive cross-sectional study of caregivers (N = 62) of children aged 6 to 11 years old diagnosed with ASD and receiving care at a regional autism research and resource center. Results: Participants completed the Sleep Habits Questionnaire (SHQ), the Medical Outcomes Study (MOS) SF-12, and the Beach Center Family Quality of Life Scale (FQoL). Caregivers with longer sleep duration reported better mental health and better family quality of life. Caregivers who reported insomnia symptoms, non-restorative sleep, and insufficient sleep were more likely to report poorer mental health than caregivers who did not report these sleep disorder symptoms. Caregivers with obstructive sleep apnea and restless legs syndrome experienced worse physical quality of life. Conclusions: The physical and mental health of the primary caregiver is essential to the support of the child with ASD and to the functioning of the family. The study findings point to the importance of future research and interventions to enhance sleep health in order to improve quality of life for caregivers of children with ASD.
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Affiliation(s)
- Maureen Russell
- Institute for Human Development, Northern Arizona University, Flagstaff, AZ 86011, USA;
| | - Carol M. Baldwin
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85287, USA;
| | - Stuart F. Quan
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine, University of Arizona, Tucson, AZ 85724, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
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Tooth wear prevalence in individuals with Down syndrome: a systematic review. Clin Oral Investig 2023; 27:943-953. [PMID: 36629964 DOI: 10.1007/s00784-022-04856-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 12/29/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES This systematic review investigated the prevalence of tooth wear between patients with and without Down syndrome. METHODS Six databases (Embase, LILACS, Livivo, PubMed, Scopus and Web of Science) and grey literature (Google Scholar, OpenGrey and ProQuest) were searched until March 7, 2022. Observational studies were included to assess the differences in tooth wear prevalence and/or severity in Down syndrome and non-syndromic controls. Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) recommendations were followed. Three reviewers independently screened studies, extracted data, assessed the methodological quality (Joanna Briggs Institute) and graded the certainty of evidence through the Grading of Recommendations, Assessment, Development, Evaluation (GRADE) approach. Results were summarized through meta-analyses using a random-effects model. The protocol was registered at PROSPERO (CRD42021266997). RESULTS Of the 1382 records identified, six cross-sectional studies were included. Individuals with Down syndrome had a higher prevalence and were more likely to have tooth wear than individuals without Down syndrome (44% × 15%; OR = 4.43; 95% CI 3.17-6.18; p < 0.00001; I2 = 8%). Also, the severity of tooth wear was higher in the Down syndrome group (n = 275) compared with the controls (n = 294). The certainty of evidence analysis was very low. CONCLUSIONS Based on very low certainty of the evidence, patients with Down syndrome had a higher prevalence and likelihood and severity of tooth wear when compared to those without Down syndrome. CLINICAL RELEVANCE Screening early tooth wear lesions should be carefully done in the Down syndrome population since its occurrence is remarkable compared to the general population.
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Lived experience of patients with sleep apnea: a systematic synthesis of qualitative evidence. Qual Life Res 2023; 32:1447-1467. [PMID: 36593431 DOI: 10.1007/s11136-022-03332-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Sleep apnea (SA) is a prevalent chronic disease with significant morbidity that negatively impacts a patient's perception of health and quality of life (QoL). OBJECTIVE This review synthesized qualitative evidence on the experiences of patients living with SA to understand the disease's impacts on QoL. METHODS We performed a systematic review of qualitative studies and searched eight electronic databases from inception dates to 22 September 2020. We analyzed the data using Sandelowski's proposed method of meta-synthesis, and applied Critical Appraisal Skills Program (CASP) and GRADE-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) criteria to appraise the studies' qualities, and synthesized findings, respectively. RESULTS Fourteen qualitative studies met the selection criteria. Four themes and 16 subthemes emerged: (1) sleep-related manifestations (n = 14) with four subthemes (sleep disruptors; sleepiness & napping; fatigue & low energy level; decreased cognition), (2) reduced psychological well-being and functioning (n = 14) with seven subthemes (anxiety & feeling vulnerable; hostility; sadness, sense of hopelessness & depression; embarrassment, shame & diminished self-concept; guilt & self-blame; maladaptive coping; self-stigma, (3) impaired physical and role functioning (n = 13) with three subthemes (reduced activities & routine disruption; reduced sexual activities & desire; reduced job performance & participation), (4) impaired social and relational functioning (n = 13) with two subthemes (strained interpersonal relationships; social isolation & loneliness). CONCLUSIONS SA patients experienced sleep-disrupting symptoms and daytime sleepiness/fatigue which adversely impacted physical, psycho-cognitive, and social aspects of their lives in complex interactive ways. This understanding can help facilitate patient-centric care and develop comprehensive patient-reported measures to effect good health outcomes.
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Hua F. DENTAL PATIENT-REPORTED OUTCOMES UPDATE 2022. J Evid Based Dent Pract 2023; 23:101802. [PMID: 36707164 DOI: 10.1016/j.jebdp.2022.101802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/16/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
Much progress has been made this year in patient-reported outcomes related research. A number of important articles were published, shedding light on relevant methodological issues as well as future directions. In order to further promote the wide use of dental patient-reported outcomes (dPROs) and dental patient-reported outcome measures (dPROMs) in dental research and dental practice, and to provide novel insights into relevant measurement and analytical methods, the Journal of Evidence-Based Dental Practice has put together this special issue, the second of a series entitled Dental Patient-Reported Outcomes Update. To put Special Issue articles into a broader perspective, this review will provide a concise summary of key, relevant PRO and dPRO articles published during the year of 2022. A brief introduction of those manuscripts collected in this Special Issue follows. Six main domains are covered in this Special Issue: (i) the availability and applicability of dPROs and dPROMs, (ii) the current usage of dPROs and dPROMs in published research, (iii) methodological considerations in dPRO-related research, (iv) the landscape and trends of dPRO-related research, (v) the significance and relevance of dPRO usage, and (vi) dPROs and value-based oral health care.
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Affiliation(s)
- Fang Hua
- Hubei-MOST KLOS & KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China; Center for Evidence-Based Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China; Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School and Hospital of Stomatology, Wuhan University, Wuhan, China; Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.
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8
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Ye L, Mages MA, Jimison HB, Patel SR. Developing OurSleepKit: A Couple-focused mHealth Tool to Support Adherence to Positive Airway Pressure Treatment. Behav Sleep Med 2022; 20:695-705. [PMID: 34591739 PMCID: PMC8964838 DOI: 10.1080/15402002.2021.1984239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIM Existing interventions promoting positive airway pressure (PAP) adherence focus only on the diagnosed individual, despite the fact that partners are often the most impacted by obstructive sleep apnea (OSA), and are delivered mostly by health professionals, with limited success. The goal of this work is to develop a prototype of OurSleepKit, a couple-focused mobile health (mHealth) tool to coach mutual engagement and promote adherence to PAP treatment. METHODS We used an iterative participatory approach working with future end users of OurSleepKit to support the development of this prototype. We conducted a total of 14 semi-structured in-depth open-ended dyadic interviews with OSA patients and their partners. Phase 1 of the development was to inform key functions of an engaging tool. Phase 2 focused on developing functions to engage positive conversation in the dyad and obtained feedback for this initial prototype. RESULTS The OurSleepKit prototype was developed and demonstrated high acceptability and engagement. Three key functions included periodic assessments based on developmental stages of PAP treatment, a Coaching Board which provides customized and dynamically updated support content - primarily brief story-telling videos featuring real-life couples' experiences - and timely tailored prompts (for action, learning, and conversation) through push notifications in the evening to facilitate positive conversation in the dyad and offer in-the-moment support for PAP use. CONCLUSIONS Going beyond the traditional and prevailing view of PAP use as an individual phenomenon, OurSleepKit is a novel mHealth intervention engaging both the patient and partner holding great promise to promote PAP adherence.
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Affiliation(s)
- Lichuan Ye
- Bouvé College of Health Sciences School of Nursing, Northeastern University, Boston, MA, USA
| | | | - Holly B. Jimison
- Bouvé College of Health Sciences School of Nursing, Northeastern University, Boston, MA, USA
- Khoury College of Computer & Information Science, Northeastern University, Boston, MA, USA
| | - Sanjay R. Patel
- Division of Pulmonary, Critical Care & Sleep Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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OSA Wellness Scale (OWS): A New Health-Related Quality of Life Test in Obstructive Sleep Apnea Patients Treated with Mandibular Advancement Device. Int J Dent 2022; 2022:4629341. [PMID: 36187733 PMCID: PMC9519331 DOI: 10.1155/2022/4629341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/27/2022] [Accepted: 08/24/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives. To present a new short self-test, called the OSA wellness scale (OWS), for assessing the health-related quality of life (HRQoL) changes in obstructive apnea syndrome (OSA) patients treated with mandibular advancement device (MAD). Methods. 51 OSA patients (8 women and 43 men, mean age 52.3) treated with a fully customizable MAD device (Protrusor) were retrospectively enrolled. Each patient received a home sleep apnea testing (HSAT) at baseline (T0) and after three months of MAD treatment (T1). Two self-test evaluations, the Epworth sleepiness scale (ESS), and OWS were also submitted at T0 and T1. The OWS was a short self-test of 8 questions for evaluating the daytime HRQoL. Patients gave an assessment from 0 to 3 for each question. At the end of the questionnaire, the patients had a score from 0 to 24, resulting from the sum of all 8 scores. The higher the score, the greater the patient’s perceived state of discomfort. Results. At T1, a significant decrease in the oxygen desaturation index (ODI) and apnea-hypopnea index (AHI) was shown (
), while no significant changes in body mass index (BMI) were found. Both the ESS and the OWS records showed a significant reduction in daytime sleepiness and HRQoL (
). Conclusion. The OWS could be a useful method to verify and numerically compare the perceived quality of life in OSA patients, before and after MAD therapy.
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Pauletto P, Polmann H, Conti Réus J, Massignan C, de Souza BDM, Gozal D, Lavigne G, Flores-Mir C, De Luca Canto G. Sleep bruxism and obstructive sleep apnea: association, causality or spurious finding? A scoping review. Sleep 2022; 45:6571501. [DOI: 10.1093/sleep/zsac073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/26/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study Objectives
To evaluate the available evidence on the putative relationships between sleep bruxism (SB) and, obstructive sleep apnea (OSA) to assess the extent of research on this topic, and to formulate suggestions for future research.
Methods
A scoping review including studies examining temporal and overall association and prevalence of SB and OSA was performed. Six main databases and gray literature were searched. The studies selection was conducted by three independent reviewers. A narrative synthesis of the results was carried out.
Results
Thirteen studies in adults and eight studies in children were finally included. The median of concomitant conditions prevalence was 39.3% in adults and 26.1% in children. Marked methodological variability was identified among studies in adults and even more when we compared detection methods in children. No significant association between OSA and SB emerged in most studies in adults, while an association may be possible in children.
Conclusions
Based on the current literature, it is not possible to confirm that there is a relationship between SB and OSA in adults. In patients under pediatric care, although this association seems plausible, there is currently insufficient supportive evidence. Standardized validated methodologies for identifying SB should be consistently used in both populations before reaching any conclusion regarding such association. Furthermore, assessment of shared phenotypes between patients with SB and patients with OSA may reveal new insights that will contribute to personalized approaches aiming to optimize the management of such comorbidities.
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Affiliation(s)
- Patrícia Pauletto
- Department of Dentistry, Federal University of Santa Catarina , Florianópolis , Brazil
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina , Florianópolis , Brazil
| | - Helena Polmann
- Department of Dentistry, Federal University of Santa Catarina , Florianópolis , Brazil
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina , Florianópolis , Brazil
| | - Jéssica Conti Réus
- Department of Dentistry, Federal University of Santa Catarina , Florianópolis , Brazil
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina , Florianópolis , Brazil
| | - Carla Massignan
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina , Florianópolis , Brazil
- Department of Dentistry, University of Brasília , Brasília , Brazil
| | | | - David Gozal
- Department of Child Health, University of Missouri , Columbia, Missouri , United States
| | - Gilles Lavigne
- Department of Dentistry, Faculty of Dental Medicine, Université de Montreal, Montréal , Canada
| | | | - Graziela De Luca Canto
- Department of Dentistry, Federal University of Santa Catarina , Florianópolis , Brazil
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina , Florianópolis , Brazil
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Iannella G, Magliulo G, Lo Iacono CAM, Visconti IC, Lechien JR, Perrone T, Cammaroto G, Meccariello G, Maniaci A, Cocuzza S, Di Luca M, De Vito A, Martone C, Polimeni A, Greco A, de Vincentiis M, Ralli M, Pace A, Gulotta G, Pelucchi S, Eplite A, Vicini C. Quality of Life and Excessive Daytime Sleepiness in Adults with Obstructive Sleep Apnea Who Are Treated with Multilevel Surgery or Adherent to Continuous Positive Airway Pressure. J Clin Med 2022; 11:2375. [PMID: 35566499 PMCID: PMC9103957 DOI: 10.3390/jcm11092375] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/19/2022] [Accepted: 04/22/2022] [Indexed: 12/15/2022] Open
Abstract
Obstructive Sleep Apnea (OSA) syndrome is a respiratory sleep disorder characterized by a reduction (hypopnea) in or a complete cessation (apnea) of airflow in the upper airways at night, in the presence of breathing effort. The gold standard treatment for OSA is ventilation through continuous positive airway pressure (CPAP), although this often shows poor patient compliance. In recent years, transoral robotic surgery (TORS) has been proposed as a valid surgical treatment for patients suffering from OSA in a multilevel surgical setting. The aim of this study is to analyze the effects on QoL and daytime sleepiness of multilevel surgery for OSA (barbed pharyngoplasty + transoral robotic surgery). Furthermore, we compared the impact on QoL and daytime sleepiness of two different treatments for patients with moderate to severe OSA, such as CPAP and TORS. Sixty-seven OSA patients who underwent multilevel robotic surgery and sixty-seven OSA patients treated with CPAP were enrolled, defined as Group 1 and Group 2, respectively. The Glasgow Benefit Inventory (GBI) questionnaire was administrated to evaluate the changes in the QoL. Respiratory outcomes were evaluated and compared. Group 1 showed a GBI total average value of +30.4, whereas Group 2, a value of +33.2 (p = 0.4). General benefit score showed no difference between groups (p = 0.1). Better values of social status benefit (p = 0.0006) emerged in the CPAP Group, whereas greater physical status benefit (p = 0.04) was shown in the TORS Group. Delta-AHI (-23.7 ± 14.3 vs. -31.7 ± 15.6; p = 0.001) and Delta-ODI (-24.5 ± 9.5 vs. -29.4 ± 10.5; p = 0.001) showed better values in the CPAP group. Therapeutic success rate of the Multilevel TORS Group was 73.1% and 91% in the CPAP group (p = 0.01), respectively. Multilevel TORS and CPAP have a positive effect on the quality of life of OSA patients. Greater social support has been reported in the CPAP group and better physical health status in the TORS group. No statistical difference emerged in the reduction in daytime sleepiness between both groups.
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Affiliation(s)
- Giannicola Iannella
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, Italy; (G.I.); (G.M.); (C.V.)
- Department of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, Italy; (G.M.); (I.C.V.); (A.P.); (A.G.); (M.d.V.); (M.R.); (A.P.); (G.G.)
| | - Giuseppe Magliulo
- Department of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, Italy; (G.M.); (I.C.V.); (A.P.); (A.G.); (M.d.V.); (M.R.); (A.P.); (G.G.)
| | - Cristina Anna Maria Lo Iacono
- Department of Cardiovascular, Respiratory, Nephrologic, Anaesthesiologic and Geriatric Sciences, Sapienza University, Viale dell’Università, 33, 00185 Rome, Italy;
| | - Irene Claudia Visconti
- Department of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, Italy; (G.M.); (I.C.V.); (A.P.); (A.G.); (M.d.V.); (M.R.); (A.P.); (G.G.)
| | - Jerome R. Lechien
- Laboratory of Anatomy and Cell Biology, Faculty of Medicine, University of Mons (UMONS), Avenue du Champ de Mars, 6, B7000 Mons, Belgium; (J.R.L.); (S.P.)
| | - Tiziano Perrone
- Department ENT & Audiology, University of Ferrara, Via Savonarola, 9, 44121 Ferrara, Italy;
| | - Giovanni Cammaroto
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, Italy; (G.I.); (G.M.); (C.V.)
| | - Giuseppe Meccariello
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, Italy; (G.I.); (G.M.); (C.V.)
| | - Antonino Maniaci
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, Via S. Sofia, 78, 95125 Catania, Italy; (A.M.); (S.C.); (M.D.L.)
| | - Salvatore Cocuzza
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, Via S. Sofia, 78, 95125 Catania, Italy; (A.M.); (S.C.); (M.D.L.)
| | - Milena Di Luca
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, Via S. Sofia, 78, 95125 Catania, Italy; (A.M.); (S.C.); (M.D.L.)
| | - Andrea De Vito
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Ospedale “Santa Maria delle Croci”, Viale Vincenzo Randi, 5, 48121 Ravenna, Italy; (A.D.V.); (C.M.)
| | - Chiara Martone
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Ospedale “Santa Maria delle Croci”, Viale Vincenzo Randi, 5, 48121 Ravenna, Italy; (A.D.V.); (C.M.)
| | - Antonella Polimeni
- Department of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, Italy; (G.M.); (I.C.V.); (A.P.); (A.G.); (M.d.V.); (M.R.); (A.P.); (G.G.)
| | - Antonio Greco
- Department of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, Italy; (G.M.); (I.C.V.); (A.P.); (A.G.); (M.d.V.); (M.R.); (A.P.); (G.G.)
| | - Marco de Vincentiis
- Department of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, Italy; (G.M.); (I.C.V.); (A.P.); (A.G.); (M.d.V.); (M.R.); (A.P.); (G.G.)
| | - Massimo Ralli
- Department of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, Italy; (G.M.); (I.C.V.); (A.P.); (A.G.); (M.d.V.); (M.R.); (A.P.); (G.G.)
| | - Annalisa Pace
- Department of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, Italy; (G.M.); (I.C.V.); (A.P.); (A.G.); (M.d.V.); (M.R.); (A.P.); (G.G.)
| | - Giampiero Gulotta
- Department of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, Italy; (G.M.); (I.C.V.); (A.P.); (A.G.); (M.d.V.); (M.R.); (A.P.); (G.G.)
| | - Stefano Pelucchi
- Laboratory of Anatomy and Cell Biology, Faculty of Medicine, University of Mons (UMONS), Avenue du Champ de Mars, 6, B7000 Mons, Belgium; (J.R.L.); (S.P.)
| | - Angelo Eplite
- ENT Department, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy;
| | - Claudio Vicini
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, Italy; (G.I.); (G.M.); (C.V.)
- Department ENT & Audiology, University of Ferrara, Via Savonarola, 9, 44121 Ferrara, Italy;
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12
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Ciavarella D, Campobasso A, Suriano C, Lo Muzio E, Guida L, Salcuni F, Laurenziello M, Illuzzi G, Tepedino M. A new design of mandibular advancement device (IMYS) in the treatment of obstructive sleep apnea. Cranio 2022:1-8. [PMID: 35171757 DOI: 10.1080/08869634.2022.2041271] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The mandibular advancement device (MAD) is currently suggested in patients with mild to moderate obstructive sleep apnea (OSA). This study investigated the effects of a new fully customizable MAD-type device called, "It Makes You Sleep" (IMYS), in patients with mild to moderate OSA. METHODS Sixteen patients (14 men and 2 women; mean age 62; SD ± 11 years) were retrospectively enrolled. Each patient received home sleep apnea testing (HSAT) at baseline (T0) and after three months (T1) of IMYS treatment. The Apnea-Hypopnea Index (AHI), the Oxygen Desaturation Index (ODI), the Minimum Oxygen Saturation (minSO2) and the Medium Oxygen Saturation (medSO2) were analyzed. RESULTS From T0 to T1, the IMYS treatment showed a significant reduction of AHI and ODI and a significant increase of minSO2 and medSO2. CONCLUSION The IMYS appliance is an effective device for treating mild or moderate OSA.
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Affiliation(s)
- Domenico Ciavarella
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Alessandra Campobasso
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Carmela Suriano
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | | | - Laura Guida
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Fabio Salcuni
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Michele Laurenziello
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Gaetano Illuzzi
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Michele Tepedino
- Department of Biotecnologica and Applied Clinical Sciences, Dental School of L'Aquila, University of L'Aquila, L'Aquila, Italy
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13
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Li S, Ning W, Wang W, Ziebolz D, Acharya A, Schmalz G, Zhao J, Huang S, Xiao H. Oral Health-Related Quality of Life in Patients With Chronic Respiratory Diseases-Results of a Systematic Review. Front Med (Lausanne) 2022; 8:757739. [PMID: 35096862 PMCID: PMC8790480 DOI: 10.3389/fmed.2021.757739] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 12/13/2021] [Indexed: 01/21/2023] Open
Abstract
Background: This systematic review evaluates the oral health-related quality of life (OHRQoL) of patients with chronic respiratory diseases. Methods: A systematic literature search was performed based on the PubMed, Medline, Web of Science, and Scopus, using the search terms: “oral health-related quality of life” and “respiratory disease” or “lung” and “oral health-related quality of life.” Full-text articles published until June 30, 2021 and reporting any OHRQoL measurement in children or adults with a chronic respiratory disease or condition were included and analyzed qualitatively. Results: A total of seven out of 44 studies were included, of which four studies examined adults and three studies investigated children. The respective diseases were chronic obstructive pulmonary disease (COPD) (n = 2), sleep apnea (n = 2), severe asthma (n = 1), cystic fibrosis (n = 1), and lung transplantation (n = 1). Four studies confirmed a worse OHRQoL in the respiratory diseased group compared to healthy controls. The overall OHRQoL was reduced in the included studies. Oral health, health-related quality of life, and disease-related parameters were rarely examined with regard to OHRQoL. Conclusion: Patients with chronic respiratory diseases show a reduced OHRQoL. Oral health should be fostered in these individuals to support their OHRQoL.
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Affiliation(s)
- Simin Li
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Wanchen Ning
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Wei Wang
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
| | - Aneesha Acharya
- Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
| | - Jianjiang Zhao
- Shenzhen Stomatological Hospital, Southern Medical University, Shenzhen, China
| | - Shaohong Huang
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Hui Xiao
- Stomatological Hospital, Southern Medical University, Guangzhou, China
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14
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Impact of Frailty on Hippocampal Volume in Patients with Chronic Obstructive Pulmonary Disease. Biomedicines 2021; 9:biomedicines9091103. [PMID: 34572291 PMCID: PMC8468719 DOI: 10.3390/biomedicines9091103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/22/2021] [Accepted: 08/25/2021] [Indexed: 12/11/2022] Open
Abstract
Brain frailty may be related to the pathophysiology of poor clinical outcomes in chronic obstructive pulmonary disease (COPD). This study examines the relationship between hippocampal subfield volumes and frailty and depressive symptoms, and their combined association with quality of life (QOL) in patients with COPD. The study involved 40 patients with COPD. Frailty, depressive symptoms and QOL were assessed using Kihon Checklist (KCL), Hospital Anxiety and Depression Scale (HADS), and World Health Organization Quality of Life Assessment (WHO/QOL-26). Anatomical MRI data were acquired, and volumes of the hippocampal subfields were obtained using FreeSurfer (version 6.0). Statistically, HADS score had significant association with WHO/QOL-26 and KCL scores. KCL scores were significantly associated with volumes of left and right whole hippocampi, presubiculum and subiculum, but HADS score had no significant association with whole hippocampi or hippocampal subfield volumes. Meanwhile, WHO/QOL-26 score was significantly associated with volume of the left CA1. There was a significant association between frailty, depression, and QOL. Hippocampal pathology was related to frailty and, to some extent, with QOL in patients with COPD. Our results suggest the impact of frailty on hippocampal volume and their combined associations with poor QOL in COPD.
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