Abstract:Contrary to previous studies, we found that OSA patients may experience more apneic events if they sleep with their dentures in place. Specifically, in mild OSAS patients, the use of dentures substantially increases the AHI especially when in the supine position.
“…Similarly, ARISAKA et al [63] found that wearing dentures during sleep improved the apnoeas and hypopneas in 70% of individuals but interestingly, 14% showed a significant increase in the AHI while wearing dentures. This controversial aspect was confirmed by ALMEIDA et al [64], who conducted a randomised trial and found an aggravation of OSA while wearing dentures. This worsening of OSA was predominantly related to individuals with mild OSA sleeping in the supine position [64].…”
Section: Denture Wearing At Nightmentioning
confidence: 87%
“…This controversial aspect was confirmed by ALMEIDA et al [64], who conducted a randomised trial and found an aggravation of OSA while wearing dentures. This worsening of OSA was predominantly related to individuals with mild OSA sleeping in the supine position [64].…”
Sleep disordered breathing (SDB) is a leading cause of morbidity worldwide. Its prevalence increases with age. Due to the demographic changes in industrial societies, pulmonologists and sleep physicians are confronted with a rapidly growing number of elderly SDB patients. For many physicians, it remains unclear how current guidelines for SDB management apply to elderly and frail elderly patients. The goal of this consensus statement is to provide guidance based on published evidence for SDB treatment in this specific patient group.Clinicians and researchers with expertise in geriatric sleep medicine representing several countries were invited to participate in a task force. A literature search of PubMed from the past 12 years and a systematic review of evidence of studies deemed relevant was performed.Recommendations for treatment management of elderly and frail elderly SDB patients based on published evidence were formulated via discussion and consensus.In the last 12 years, there have been surprisingly few studies examining treatment of SDB in older adults and even fewer in frail older adults. Studies that have been conducted on the management of SDB in the older patient population were rarely stratified for age. Studies in SDB treatment that did include age stratification mainly focused on middle-aged and younger patient groups. Based on the evidence that is available, this consensus statement highlights the treatment forms that can be recommended for elderly SDB patients and encourages treatment of SDB in this large patient group. @ERSpublications An overview of the research in the field of and clinical guidelines for the treatment of SDB in elderly patients
“…Similarly, ARISAKA et al [63] found that wearing dentures during sleep improved the apnoeas and hypopneas in 70% of individuals but interestingly, 14% showed a significant increase in the AHI while wearing dentures. This controversial aspect was confirmed by ALMEIDA et al [64], who conducted a randomised trial and found an aggravation of OSA while wearing dentures. This worsening of OSA was predominantly related to individuals with mild OSA sleeping in the supine position [64].…”
Section: Denture Wearing At Nightmentioning
confidence: 87%
“…This controversial aspect was confirmed by ALMEIDA et al [64], who conducted a randomised trial and found an aggravation of OSA while wearing dentures. This worsening of OSA was predominantly related to individuals with mild OSA sleeping in the supine position [64].…”
Sleep disordered breathing (SDB) is a leading cause of morbidity worldwide. Its prevalence increases with age. Due to the demographic changes in industrial societies, pulmonologists and sleep physicians are confronted with a rapidly growing number of elderly SDB patients. For many physicians, it remains unclear how current guidelines for SDB management apply to elderly and frail elderly patients. The goal of this consensus statement is to provide guidance based on published evidence for SDB treatment in this specific patient group.Clinicians and researchers with expertise in geriatric sleep medicine representing several countries were invited to participate in a task force. A literature search of PubMed from the past 12 years and a systematic review of evidence of studies deemed relevant was performed.Recommendations for treatment management of elderly and frail elderly SDB patients based on published evidence were formulated via discussion and consensus.In the last 12 years, there have been surprisingly few studies examining treatment of SDB in older adults and even fewer in frail older adults. Studies that have been conducted on the management of SDB in the older patient population were rarely stratified for age. Studies in SDB treatment that did include age stratification mainly focused on middle-aged and younger patient groups. Based on the evidence that is available, this consensus statement highlights the treatment forms that can be recommended for elderly SDB patients and encourages treatment of SDB in this large patient group. @ERSpublications An overview of the research in the field of and clinical guidelines for the treatment of SDB in elderly patients
“…Minimal or no carry-over effect is expected based on the action of the postulated mechanism of intervention [28] (additional analyses of raw data from research team member FRA: Grizzle’s model [43] sequence effect P = 0.8, period effect P = 0.9, intervention effect P = 0.002). Therefore, no wash-out period was deemed necessary.Figure 1
Trial design.…”
Section: Methodsmentioning
confidence: 99%
“…Furthermore, the literature suggests that there is a possible association between sleep disturbance and wearing a complete denture during sleep, which may explain the mechanism underlying the relationship between obstructive sleep apnea and edentate individuals [26, 27]. One hypothesized effect was that the use of a denture during sleep may lead to open bite and mouth breathing with a decrease in the tone of the pharyngeal muscles, thus leading to the development or worsening of obstructive sleep apnea [28]; an alternative hypothesis holds that sleep quality and pharyngeal patency are maintained by nocturnal denture use. Moreover, this denture effect appears to be different between healthy edentate older people and those with sleep disturbances [29].…”
Section: Introductionmentioning
confidence: 99%
“…Specifically, a rigorous randomized trial is needed to help determine the effects of denture wearing on patient-relevant outcomes [28, 39–41]. …”
BackgroundEdentulism and sleep disturbance are chronic conditions that are common in older people and have serious adverse consequences for their functioning and quality of life. Edentulism can disturb sleep through the alteration of the craniofacial structure and surrounding soft tissue. However, the effect of prosthetic rehabilitation of edentulism on sleep quality is still not well understood. The objectives of this study are to test whether nocturnal denture wear affects sleep quality, daytime sleepiness, and the oral health related quality of life of edentate older people with moderate to severe sleep apnea, and to identify modifiers of effect of nocturnal denture wear.Methods/designWe will carry out a single-blind randomized cross-over trial. Seventy edentate older people with moderate to severe obstructive sleep apnea will be enrolled. The study participants will be assigned to wear and not wear their dentures on alternate periods of 30 days. The outcome measures will be sleep quality (assessed by portable polysomnography), daytime sleepiness (assessed by the Epworth Sleepiness Scale), and oral health related quality of life (assessed by validated questionnaire). A number of characteristics (sociodemographic, oropharyngeal morphology, oral and prosthesis characteristics, and perceived general health quality of life) will be assessed by means of clinical examination, 3D imaging of the craniofacial structure, and validated questionnaires at baseline. Linear mixed effects regression models for repeated measures will be fitted to test the study hypotheses. The main analyses will be based on the intention-to-treat principle. To assess the robustness of the findings to potential incomplete adherence, sensitivity analyses will be conducted while applying the per-protocol principle.DiscussionThis practice-relevant evidence could represent a preventive approach to improve sleep characteristics of the older population and improve their well-being and quality of life.Trial registrationClinicalTrials.gov NCT01868295.
The objective of this study was to test the construct validity of the patient-reported outcomes Swallowing Quality of Life Questionnaire (SWAL-QOL) and Speech Handicap Index (SHI) in relation to objectively measured oral function among patients treated for oral or oropharyngeal cancer. The study sample consisted of patients treated for oral or oropharyngeal cancer. Outcome measures were the SWAL-QOL and the SHI, and the Functional Rehabilitation Outcomes Grade (FROG), a test to measure oral and shoulder function. Spearman's rank correlation coefficient was used to test associations between the SHI and SWAL-QOL scales, and the FROG scales. During a study period of 3 months, 38 patients (21 males, 17 females; mean age 54 years) were included who visited the outpatient clinic for follow-up care 6-155 months after surgical treatment (n = 14) or combined surgery and radiotherapy (n = 24) for oral (n = 21) or oropharyngeal cancer (n = 17). Most SWAL-QOL and SHI scales (except the SWAL-QOL Fatigue scale) correlated significantly with one or more FROG oral function scales. None of the SWAL-QOL and SHI scales correlated significantly with the FROG shoulder function scale. These results support the construct validity of the SWAL-QOL and SHI questionnaires for assessing speech and swallowing problems in daily life that are moderately but significantly related to oral function. A multidimensional assessment protocol is recommended for use in clinical practice and for research purposes for measuring oral function and swallowing- and speech-related problems in daily life among head and neck cancer patients.
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