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Innovations and New Technologies in Obstructive Sleep Apnea and Snoring...
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Innovations and New Technologies in Obstructive Sleep Apnea and Snoring in the Era of Precision Medicine

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 5341

Special Issue Editors

Dr. Antonio Moffa

E-Mail Website
Guest Editor
School of Medicine, Campus Bio-Medico University, Via Alvaro del Portillo 21, 00128 Rome, Italy
Interests: otolaryngology; obstructive sleep apnea; snoring
Prof. Dr. Manuele Casale

E-Mail Website
Guest Editor
School of Medicine, Campus Bio-Medico University, Fondazione Policlinico Campus Bio-Medico Rome Italy, Via A. del Portillo 200, 00128 Rome, Italy
Interests: sinusitis; sleep apnea syndrome; rhinology; new surgical devices in ENT
Special Issues, Collections and Topics in MDPI journals
Dr. Peter Baptista

E-Mail Website
Guest Editor
Department of Otolaryngology Head and Neck Surgery, Clínica Universitaria de Navarra, 31008 Pamplona, Spain
Interests: rhinology; snoring; obstructive sleep apnea surgery; endoscopic sinus surgery

Special Issue Information

Dear Colleagues,

Obstructive sleep apnea (OSA) is the most common form of sleep-disordered breathing and is characterised by recurrent episodes of complete or partial upper airway obstruction during sleep, resulting in oxygen desaturation, autonomic dysfunction, and sleep fragmentation. If untreated, OSA may cause excessive daytime sleepiness, hypertension, type 2 diabetes, cerebrovascular incidents, and even sudden cardiac death. Although OSA is very common, it is a frequently unrecognised cause of serious disability with serious health and social consequences.  Currently, OSA can be diagnosed with several methods from laboratory-based to home sleep testing. To date, the gold standard method is full-night polysomnography (PSG). However, it is an expensive examination (equipment, maintenance costs, staff costs, and full-night-time occupation of the laboratory), and it can also be annoying due to the attached sensors and the exam taking place in an unfamiliar place. For these reasons, cheaper and portable devices have been developed to detect OSA outside the hospital setting. Continuous positive airway pressure (CPAP) is often used as first line-treatment; however, failure in long-term adherence to CPAP treatment was reported in 25–50% of cases. For these reasons, in recent years, OSA and snoring surgical management underwent significant changes with the introduction of new surgical procedures that are less invasive or have lower morbidity, improving patients’ compliance, making OSA surgery a reasonable alternative.

We encourage authors to submit original or review articles on related topics in the field of sleep apnea.

This Special Issue of Healthcare is dedicated to offering an overview of these innovations. Topics of interest include (1) new diagnostic tools for screening, (2) telemedicine and mHealth, (3) new intrapharyngeal and hypopharyngeal surgical procedures, (4) surgical and non-surgical treatment of nasal obstruction in OSA patients, (5) myofunctional and rehabilitation therapy, (6) electrical stimulation devices, and (7) international research networks.

Groups from all specialties are encouraged to submit original research, project reports, short reports, reviews, and opinion papers.

Dr. Antonio Moffa
Prof. Dr. Manuele Casale
Dr. Peter Baptista
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sleep apnea
  • snoring
  • new technologies
  • surgical innovation
  • precision medicine

Published Papers (3 papers)

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Research

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9 pages, 459 KiB  
Article
Factors Associated with the Underestimation of Manual CPAP Titration Pressure
by Po-Yueh Chen, Nguyen-Kieu Viet-Nhi, Yen-Chun Chen, Yi-Lin Kao, Luong Huu Dang and Shih-Han Hung
Healthcare 2023, 11(10), 1436; https://doi.org/10.3390/healthcare11101436 - 15 May 2023
Viewed by 1138
Abstract
During the SARS-CoV-2 pandemic, the use of in-laboratory positive airway pressure (PAP) titration studies was not routinely suggested. PAP pressure prediction calculations are emerging as alternative methods for the treatment of these patients. The underestimation of PAP titration pressure usually leads to unsatisfactory [...] Read more.
During the SARS-CoV-2 pandemic, the use of in-laboratory positive airway pressure (PAP) titration studies was not routinely suggested. PAP pressure prediction calculations are emerging as alternative methods for the treatment of these patients. The underestimation of PAP titration pressure usually leads to unsatisfactory results for PAP therapy. This study aimed to evaluate the factors associated with the underestimation of PAP titration pressure when using PAP pressure prediction equations. Estimated PAP pressure formulas based on body mass index (BMI) and apnea-hypopnea index (AHI) were chosen to validate the accuracy of equations in the successful prediction of titration pressure. Among 341 adult patients diagnosed with obstructive sleep apnea (OSA) by overnight polysomnography (PSG) and who received overnight PAP titration in order to select a successful pressure, the mean age of the total subjects was 55.4 years old and 78.9% of patients were male. The average BMI and AHI scores were 27.1 ± 4.8 and 37 ± 21.7, respectively. After multivariate stepwise regression analysis, the odds ratio of participants with a pretitration AHI was 1.017 (95% CI: 1.005–1.030). Only the severity of OSA was significantly different between the underestimated group and the adequately assessed group. In conclusion, a high AHI, but not BMI, is associated with an underestimated CPAP titration pressure in adult patients with OSA. Full article
(This article belongs to the Special Issue Innovations and New Technologies in Obstructive Sleep Apnea and Snoring in the Era of Precision Medicine)
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6 pages, 776 KiB  
Communication
High-Definition 3D Exoscope-Assisted Barbed Pharyngoplasty for OSAS and Snoring: Better Than Live
by Manuele Casale, Antonio Moffa, Michelangelo Pierri, Peter Baptista and Lucrezia Giorgi
Healthcare 2023, 11(4), 596; https://doi.org/10.3390/healthcare11040596 - 16 Feb 2023
Cited by 2 | Viewed by 1178
Abstract
Recently, a high-definition 3D exoscope (VITOM), a new magnification system that provides a 3D image of the surgical field, has been introduced. This study aims to describe the first use of VITOM 3D technology in Barbed Pharyngoplasty (BP) for Obstructive Sleep Apnea (OSA). [...] Read more.
Recently, a high-definition 3D exoscope (VITOM), a new magnification system that provides a 3D image of the surgical field, has been introduced. This study aims to describe the first use of VITOM 3D technology in Barbed Pharyngoplasty (BP) for Obstructive Sleep Apnea (OSA). VITOM 3D technology is used to support visualization during BP in a male patient affected by severe OSA with a circular palatal collapse pattern at drug-induced sleep endoscopy. During the surgical procedure, this approach markedly improves the visualization of the surgical field through anatomic details of the oral cavity, facilitating surgical dissection and enhancing the teaching environment. It allows for a better involvement and more interactions during the surgery, as scrubbed and assistant nurses can see the surgical field and anticipate the surgeon’s choice of instrument. VITOM 3D technology, by combining a telescope with a standard endoscope, has been successfully used in various surgical disciplines and could be very useful, especially in teaching hospitals. VITOM 3D can guarantee “a real immersive” surgical experience for all participants in the operating room. Economic and efficacy studies would be conducted to support the use of a VITOM-3D exoscope in common clinical practice. Full article
(This article belongs to the Special Issue Innovations and New Technologies in Obstructive Sleep Apnea and Snoring in the Era of Precision Medicine)
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Review

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11 pages, 550 KiB  
Review
Barbed Pharyngoplasty for Snoring: Does It Meet the Expectations? A Systematic Review
by Antonio Moffa, Lucrezia Giorgi, Luca Carnuccio, Michele Cassano, Rodolfo Lugo, Peter Baptista and Manuele Casale
Healthcare 2023, 11(3), 435; https://doi.org/10.3390/healthcare11030435 - 3 Feb 2023
Cited by 1 | Viewed by 2307
Abstract
To date, the use of barbed sutures for the surgical management of patients suffering from obstructive sleep apnea and snoring with retropalatal collapse and vibration has significantly increased. A systematic review was carried out, which included clinical studies that used barbed sutures for [...] Read more.
To date, the use of barbed sutures for the surgical management of patients suffering from obstructive sleep apnea and snoring with retropalatal collapse and vibration has significantly increased. A systematic review was carried out, which included clinical studies that used barbed sutures for the treatment of snoring. A qualitative analysis, including six clinical studies, was conducted. Of these, five were studies on barbed pharyngoplasties, and one study involved a minimally invasive surgical procedure. The population consisted of 176 patients, aged 26 to 58 years old. Overall, the included studies showed a mean gain in the snoring Visual Analog Scale of 5.67 ± 1.88, with a mean preoperative value of 8.35 ± 1.17 and a postoperative value of 2.68 ± 1.27. No major complications were described. Given the lack and heterogeneity of this evidence, the conclusion calls for being cautious. In carefully selected snorers and obstructive sleep apnea patients, the use of barbed sutures could represent a valid therapeutic strategy for snoring, ensuring a statistically significant improvement in the subjective parameters. Further studies on a larger scale that assess the role of barbed pharyngoplasties in snoring surgery and more extended follow-up studies are needed in order to confirm these promising results. Full article
(This article belongs to the Special Issue Innovations and New Technologies in Obstructive Sleep Apnea and Snoring in the Era of Precision Medicine)
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