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• W2055779923 abstract "There are numerous medical and surgical treatment modalities for the management of the sleep apnea patient. Among the medical treatments, weight loss and positive pressure therapy are considered to be the most important. Surgical treatment is directed at increasing the posterior airway space. Among the surgical procedures, tracheostomy, uvulopalatopharyngoplasty (UPPP), and maxillofacial skeletal procedures are the most common. Positive pressure therapy during sleep is considered effective in limiting obstructive events during sleep. Pressure is titrated to the desired value that eliminates upper airway collapse during nocturnal polysomnography; however, despite a reported 65% to 90% compliance rate with positive airway pressure therapy when compliance is assessed by subjective patient reports, long-term compliance is less than optimal when objectively monitored. Kribbs et al [1] used continuous positive airway pressure (CPAP) machines that contained a microprocessor and a monitor that measured actual pressure at the mask for every minute of each 24-hour day for an average of 106 days per patient. Patients were not aware of the monitor inside the CPAP machines. Although 60% of patients claimed to use CPAP nightly, only 16 of 35 (46%) met the criteria for regular use, which was defined as at least 4 hours of CPAP therapy administered on 70% of the days monitored [1]. There is proof that part-time use of CPAP is not satisfactory in controlling obstructive sleep apnea (OSA) [2,3]. Intolerance of CPAP therapy because of poor mask fit, claustrophobia, difficulty with exhaling, air temperature (too cold or too warm), or machine noise as well as the cumbersomeness and inconvenience in general may lead to decreased compliance. Acceptance of treatment may be improved with bilevel positive airway pressure (BiPAP), although a study published by ReevesHoche and coworkers [4] indicated that in patients who do not accept therapy for home use, compliance is the same for both CPAP and BiPAP systems. Consequently, the option of surgery should be offered to OSA patients who fail to comply with home positive pressure therapy and continue to suffer from heavy snoring, fragmented sleep, excessive daytime somnolence, and cognitive changes." @default.
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• W2055779923 date "2002-08-01" @default.
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• W2055779923 title "Surgical changes of posterior airway space in obstructive sleep apnea" @default.
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• W2055779923 doi "https://doi.org/10.1016/s1042-3699(02)00033-x" @default.
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