Snoring, sleep apnoea and stroke: chicken or scrambled egg?
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The high prevalence of sleep-related breathing disorders demands the development of ambulatory recording devices that can handle data with a high degree of selectivity and are easy to use and to interpret. A digital device based on the recording of heart rate and breathing sounds was developed. Patients with sleep-related breathing disorders can be preselected before they undergo sleep laboratory investigations. Treatment control can be achieved ambulatory, having an initial recording.
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Explore the source record for details and available documents.
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OBJECTIVES: Define differences in palatal and uvular dimensions between habitual snorers and healthy nonsnoring control subjects. Document the changes in palatal configuration after different types of palatoplasty. STUDY DESIGN: A prospective controlled clinical study was performed analyzing video recordings of the soft palate and oropharynx of 251 subjects (121 habitual snorers, 79 patients after laser-assisted uvulopalatoplasty ([LAUP], and 51 healthy volunteers). METHODS: The recordings were captured using a rigid endoscope with a reference measure applied to the soft palate and a mark at the junction of the soft and hard palate. Four parameters were studied in the captured pictures after correction for the distortion deformity in fiberoptic endoscopic images: 1) length of soft palate, 2) length of uvula, 3) width of uvula, and 4) distance between posterior pillars. RESULTS: Analysis showed that habitual snorers, compared with healthy volunteers have significantly increased soft palate length (P = .00001), increased uvula length (P = .0002) and width (P = .00001), and narrowed oropharyngeal isthmus (distance between the posterior pillars) (P = .04). In patients studied after LAUP, the length of the soft palate is significantly shorter (P = .00001) than in the preoperative cohort, and the oropharyngeal isthmus is significantly narrower (P = .00001). Moreover, this latter distance is significantly narrower (P = .00001) when compared with healthy volunteers. CONCLUSIONS: Habitual snorers have a long soft palate, a long wide uvula, and a narrowed oropharyngeal isthmus. LAUP shortens and tightens the elongated palate and causes a further reduction in the space between the posterior pillars.
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OBJECTIVES: (a) To evaluate the longer term orthodontic side-effects of a Herbst mandibular advancement splint (MAS) in subjects with sleep disordered breathing. (b) To determine whether these are related to dental occlusion, degree of mandibular advancement or duration of appliance wear. DESIGN: Retrospective, cohort study. SETTING: Teaching hospital dental school. PARTICIPANTS: Subjects with sleep disordered breathing who had been wearing an MAS regularly (a minimum of 5 h per night, six nights a week) for at least 2 years. Of 192 subjects who were identified, 30 fulfilled the inclusion criteria and were prepared to attend for review. INTERVENTIONS: Dental casts were obtained and BMI and Epworth Sleepiness Scale scores recorded. These data were compared with those collected when the subject was first referred. A questionnaire was completed concerning MAS use, side-effects and any problems associated with the device. MAIN OUTCOME MEASURES: Changes in incisor tooth position. RESULTS: Median duration of MAS wear was 3.64 years. Small, statistically significant reductions in both vertical (-0.4 mm) and horizontal (-0.5 mm) overlap of the incisor teeth were found. This correlated with the degree of vertical opening of the MAS but was not related to the amount of mandibular protrusion or the duration of appliance wear. CONCLUSIONS: Patients who are considered suitable for MAS should be warned that dental changes may occur. Thus referring surgeons should also be aware of this possibility.
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