RT Journal Article
SR Electronic
T1 Non-CPAP Therapies in Sleep Apnoea
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP erj00997-2010
DO 10.1183/09031936.00099710
A1 W.J. Randerath
A1 J. Verbraecken
A1 S. Andreas
A1 G. Bettega
A1 A. Boudewyns
A1 E. Hamans
A1 F. Jalbert
A1 J.R. Paoli
A1 B. Sanner
A1 I. Smith
A1 B.A. Stuck
A1 L. Lacassagne
A1 M. Marklund
A1 J.T. Maurer
A1 J.L. Pepin
A1 A. Valipour
A1 T. Verse
A1 I. Fietze
YR 2011
UL http://erj.ersjournals.com/content/early/2011/03/10/09031936.00099710.abstract
AB In view of the high prevalence and the relevant impairment of the patients with obstructive sleep apnoea syndrome (OSAS) lots of methods are offered which promise definitive cure or relevant improvement of OSAS.Efficacy of alternative treatment options in OSAS.An interdisciplinaty ERS Task Force valuated the scientific literature according to the standards of evidence-based medicine.Evidence supports the use of mandibular advancement devices in mild to moderate OSAS. Maxillomandibular osteotomy seems to be as efficient as CPAP in patients who refuse conservative treatment. Distraction osteogenesis is usefully applied in congenital micrognathia or midface hypoplasia. There is trend to improving under weight reduction. Positional therapy is clearly inferior to CPAP and long term compliance is poor. Drugs, nasal dilators, apnoea triggered muscle stimulation cannot be recommended as effective treatment of OSAS at the moment. Nasal surgery, radiofrequency tonsil reduction, tongue base surgery, uvulopalatal flap, laser midline glossectomy, tongue suspension, genioglossus advancement cannot be recommended as single interventions. Uvulopalatopharyngoplasty, pillar implants, hyoid suspension should only be considered in selected patients and potential benefits should be weighed against the risk of long-term side effects. Multilevel surgery is only a salvage procedure for OSA patients.