%0 Journal Article
%T Reduced Apnea-Hypopnea Index in Patients with Severe Sleep Apnea Syndrome as Determined by Cervical Collar and Mandibular Advancement Device Combination Therapy
%A Eugen Wang
%A Eva Lindberg
%A Florim Delijaj
%A Gustaf Levin
%J Open Journal of Immunology
%D 2016
%R 10.4172/2167-0277.1000252
%X Study Objectives: In patients with severe obstructive sleep apnea syndrome (OSAS), continuous positive airway pressure (CPAP) is first-line therapy. Compliance to CPAP is sometimes a problem, and mandibular advancement device (MAD) is then an alternative. However, this alternative is often not effective. It was hypothesized that patients suffering from OSAS would have a freer airway, resulting in a decreased apnea-hypopnea index (AHI), through use of a cervical collar (CC) to extend the neck. To study the effect of this new therapy, a randomized crossover study was conducted to compare MAD monotherapy with CC/MAD combination therapy.

Methods: Eight patients with severe OSAS (AHI>30) who had ceased to use CPAP were enrolled in the randomized crossover study. Four patients started with MAD and four with CC/MAD for one week followed by a wash-out period and then cross-over. Polygraphic sleep recordings were performed at baseline and after each therapy.

Results: The baseline AHI was 51.5 ¡À 22.5. AHI was reduced to 30.4 ¡À 23.2 through MAD monotherapy, and to 14.9 ¡À 10.2 through CC/MAD combination therapy. The effect of the combination therapy was statistically significantly (p=0.018) better than that of the monotherapy. Four patients were achieved an AHI<10/h through use of the combination therapy.

Concusions: The study showed a significant reduction in AHI scores in patients with severe OSAS through use of the CC/MAD combination therapy as compared to the MAD monotherapy. This first report indicates a new possibility for treating severe OSAS in non-compliant CPAP users.
%K Florim Delijaj
%K Gustaf Levin
%K Eva Lindberg and Eugen Wang
%K Cervical collar
%K CC/MAD combination therapy
%K Noncompliant CPAP users
%K Obstructive sleep apnea
%U https://www.longdom.org/abstract/reduced-apneahypopnea-index-in-patients-with-severe-sleep-apnea-syndrome-as-determined-by-cervical-collar-and-mandibular-30555.html