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Title
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Pathophysiological endotyping in patients treated with a mandibular advancement device and upper airway stimulation for obstructive sleep apnea
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Author
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Abstract
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| Pathophysiology of obstructive sleep apnea can be subdivided into 5 endotypic traits: site of upper airway collapse, loop gain, muscle responsiveness and arousal threshold. Each of these traits can be measured using gold standard techniques, however, these are not available in routine measurements. Currently, only the site of upper airway collapse is assessed in routine clinical practice using drug-induced sleep endoscopy. The 4 other traits are not routinely measured. Recently, however, an algorithm was developed that calculates these traits based on routine clinical polysomnography traits. Our aim was to define these traits using DISE and the algorithm, and to associate them to mandibular advancement device (MAD) and upper airway stimulation (HGNS) treatment outcome. Our research showed that OSA pathophysiology holds great promise as a patient selection tool for both MAD and HGNS treatment outcome. MAD efficacy was associated with the site of upper airway collapse, in analogy with HGNS, and with loop gain, in analogy with upper airway surgery and previous research. Regarding HGNS, the effect of site of collapse is established, yet our research adds that the other 4 endotypic traits, and especially arousal threshold, are also associated with treatment outcome. |
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Language
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English
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Publication
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Antwerpen
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Universiteit Antwerpen, Faculteit Geneeskunde en Gezondheidswetenschappen
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2020
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ISBN
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978-90-5728-668-1
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Volume/pages
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207 p.
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Note
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Vanderveken, O.M. [Supervisor]
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Wellman, A. [Supervisor]
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Verbraecken, J.A. [Supervisor]
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Heyning, Van de, P.A. [Supervisor]
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Full text (open access)
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