Sleep Apnea Syndrome (SAS) is diagnosed if, during a six-hour period of sleep, 30 or more episodes of cessation of airflow lasting 10 seconds or longer occur. In obstructive sleep apnea (OSAS), the most common type, respiratory effort continues but there is no air exchange at the level of nose and mouth. Patients of this type are most often males, complaining of excessive daytime sleepiness, who snore excessively during sleep and commonly suffer from hypertension and depression, as well as social, economic and marital difficulties. If untreated, symptoms of cardiac arrhythmia, right heart overload or failure may develop. Many become disabled for employment, and marital failures are common. Treatment has focused on medication trials and/or surgery. Of these only a permanent tracheostomy has given immediate and full relief. This approach is appropriate only for the severely impaired patient and is not always acceptable even to them. Therefore, there is a need to develop treatments for those at earlier stages or with less severe degrees of this disorder, and alternate treatments for the severely afflicted who refuse this surgery. This laboratory has developed non-invasive treatments for OSAS. One of these, a mechanical device which holds the tongue forward during sleep by suction, thus keeping the upper airway more open (the TRD), has been highly successful for approximately 50% of unselected patients. Training to change sleep posture from the supine to a side posture, and combinations of these two have proved successful for additional patients. Selection factors for these various treatments have been developed post hoc on a sample of 30. It is the aim of this proposed study to assess the psychosocial status of these patients before and after treatment, and to compare the effectiveness of the TRD, and sleep position training as single and combined treatments for patients with obstructive sleep apnea. Effective treatment involves changes in sleep symptoms (apnea frequency, length of apnea frequency, length of apneic events, etc.), reduced daytime symptoms (excessive sleepiness, hypertension), and improved waking functioning on employment, social, and marital adjustment and measures of psychopathology.
| Cartwright, R D; Diaz, F; Lloyd, S (1991) The effects of sleep posture and sleep stage on apnea frequency. Sleep 14:351-3 |
| Cartwright, R; Ristanovic, R; Diaz, F et al. (1991) A comparative study of treatments for positional sleep apnea. Sleep 14:546-52 |
