Prevention of leakage due to mouth opening through applying an oral shield device (Sominpax™) during nasal CPAP therapy of patients with obstructive sleep apnea

Foellner, Sebastian; Guth, Patricia; Jorde, Ilka; Lücke, Eva; Ganzert, Christine; Stegemann-Koniszewski, Sabine; Schreiber, Jens

doi:10.1016/j.sleep.2019.06.023

Cited by 4 publications

(6 citation statements)

References 31 publications

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“…The systematic literature search identified 7136 articles, of which 44 articles were reviewed for the full text. Among them, 29 articles (28 were in English and one was in French) comprising 6378 participants were included for the meta‐analysis (Figure 1 ; Table 1 ; Supplementary Results; Bachour et al, 2013 ; Bakker et al, 2012 ; Beecroft et al, 2003 ; Bettinzoli et al, 2014 ; Blanco et al, 2019 ; Borel et al, 2013 ; Casanova et al, 2013 ; Deshpande et al, 2016 ; Duarte et al, 2020 ; Ebben et al, 2016 ; Ebben et al, 2014 ; Ebben et al, 2012 ; Foellner et al, 2020 ; Goh et al, 2019 ; Kaminska et al, 2014 ; Lanza et al, 2018 ; Lebret et al, 2015 ; Lebret et al, 2018 ; Massie & Hart, 2003 ; Mortimore et al, 1998 ; Prosise & Berry, 1994 ; Rowland et al, 2018 ; Ryan et al, 2011 ; Schell & Soose, 2017 ; Shirlaw et al, 2019 ; Teo et al, 2011 ; Westhoff & Litterst, 2015 ; Zampogna et al, 2019 ; Zhu et al, 2013 ). The characteristics of these studies are listed in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Several studies have compared the effects of different interfaces on outcomes including residual AHI, CPAP pressure, and adherence. Yet, the results remain inconsistent (Bachour et al, 2013 ; Bakker, Neill, & Campbell, 2012 ; Beecroft et al, 2003 ; Bettinzoli et al, 2014 ; Blanco, Ernst, Salvado, & Borsini, 2019 ; Borel et al, 2013 ; Casanova et al, 2013 ; Deshpande et al, 2016 ; Duarte, Mendes, Oliveira, Magalhaes‐da‐Silveira, & Gozal, 2020 ; Ebben, Milrad, Dyke, Phillips, & Krieger, 2016 ; Ebben, Narizhnaya, Segal, Barone, & Krieger, 2014 ; Ebben et al, 2012 ; Foellner et al, 2020 ; Goh et al, 2019 ; Kaminska et al, 2014 ; Lanza et al, 2018 ; Lebret et al, 2015 ; Lebret et al, 2018 ; Massie & Hart, 2003 ; Mortimore, Whittle, & Douglas, 1998 ; Prosise & Berry, 1994 ; Rowland et al, 2018 ; Ryan et al, 2011 ; Schell & Soose, 2017 ; Shirlaw, Duce, Milosavljevic, Hanssen, & Hukins, 2019 ; Teo et al, 2011 ; Westhoff & Litterst, 2015 ; Zampogna et al, 2019 ; Zhu et al, 2013 ) as RCTs are commonly underpowered by small sample sizes, while large‐scale observational studies may be biased due to various confounders derived from participant characteristics and study design. A Cochrane systematic review (Chai et al, 2006 ) previously concluded that the optimal form of CPAP delivery interface remained unclear.…”

Section: Introductionmentioning

confidence: 99%

“…A more recent random‐effects meta‐analysis comparing the nasal masks and oronasal masks (R. G. S. Andrade et al, 2018 ) suggested that nasal masks were associated with better efficacy in lowering AHI, better adherence, and lower CPAP setting than oronasal masks. Since this meta‐analysis, more studies have compared the effects of different interfaces (Blanco et al, 2019 ; Duarte et al, 2020 ; Foellner et al, 2020 ; Goh et al, 2019 ; Lanza et al, 2018 ; Lebret et al, 2018 ; Rowland et al, 2018 ; Schell & Soose, 2017 ; Shirlaw et al, 2019 ; Zampogna et al, 2019 ). A recent systemic review for positive airway pressure treatment of adult OSA suggested that although the residual AHI was higher in oronasal interfaces than nasal interfaces, this difference may not be clinically significant (Patil et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

In search of a better CPAP interface: A network meta‐analysis comparing nasal masks, nasal pillows and oronasal masks

Chen

et al. 2022

Journal of Sleep Research

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

In search of a better CPAP interface: A network meta‐analysis comparing nasal masks, nasal pillows and oronasal masks

Chen

et al. 2022

Journal of Sleep Research

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“…In recent years, oral appliances such as mouth tape and oral shield devices have been invented and have been shown to be effective in clinical use [ 22 ]. Foellner et al [ 23 ] showed the positive effect of using an oral shield device concomitantly with nasal CPAP. Huang et al [ 12 ] also demonstrated the promising result of using novel oral patches for treating mild OSA.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Mouth-Taping in Mouth-Breathers with Mild Obstructive Sleep Apnea: A Preliminary Study

Lee

Cheng

et al. 2022

Healthcare

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Background: Many patients with obstructive sleep apnea (OSA) are mouth-breathers. Mouth-breathing not only narrows the upper airway, consequently worsening the severity of OSA, but also it affects compliance with nasal continuous positive airway pressure (CPAP) treatment. This study aimed to investigate changes in OSA by the use of mouth tape in mouth-breathers with mild OSA. Method: Mouth-breathers with mild OSA who met inclusion criteria and tolerated the sealing of the mouth were enrolled in the study. We used 3M silicone hypoallergenic tape was used to seal the mouths of the participants during sleep. The home sleep test (HST) used in this study was ApneaLink®. Subjects received both a baseline HST and an outcome HST to be used 1 week later while their mouths were taped. The changes between the baseline and the outcome HSTs were compared, and the factors that influenced the differences in the sleep-test parameters after the shift of the breathing route were analyzed. A “responder” was defined as a patient who experienced a reduction from the baseline snoring index of at least 50% under mouth-taping in the HST; otherwise, patients were considered as having a poor response. Results: A total of 20 patients with mild OSA were included. Following the taping of the mouth, a good response was found in 13 patients (65%). The median apnea/hypopnea index (AHI) decreased significantly, from 8.3 to 4.7 event/h (by 47%, p = 0.0002), especially in supine AHI (9.4 vs. 5.5 event/h, p = 0.0001). The median snoring index (SI) was also improved (by 47%, 303.8 vs. 121.1 event/h, p = 0.0002). Despite no significant difference in the mean saturation, improvements in the oxygen desaturation index (8.7 vs. 5.8, p = 0.0003) and the lowest saturation (82.5% vs. 87%, p = 0.049) were noted. The change in AHI was associated with baseline AHI (r = −0.52, p = 0.02), oxygen desaturation index (ODI) (r = −0.54, p = 0.01), and SI (r = −0.47, p = 0.04). The change in SI was strongly associated with baseline SI (r = −0.77, p = 0.001). Conclusions: Mouth-taping during sleep improved snoring and the severity of sleep apnea in mouth-breathers with mild OSA, with AHI and SI being reduced by about half. The higher the level of baseline AHI and SI, the greater the improvement was shown after mouth-taping. Mouth-taping could be an alternative treatment in patients with mild OSA before turning to CPAP therapy or surgical intervention.

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“…As per Table 4, 15 studies investigated the impact of different interfaces [22,[39][40][41][42][43][44][45][46][47][48][49][50][51][52]. A pairwise comparison between interfaces was undertaken for each outcome measure.…”

Section: Interfacesmentioning

confidence: 99%

Current treatment strategies in managing side effects associated with domiciliary Positive Airway Pressure (PAP) therapy for patients with sleep disordered breathing: A systematic review and meta-analysis

Mansell,

Devani,

Shah

et al. 2023

Clinical and Epidemiological Respiratory Sleep Medicine

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Sleep disordered breathing is commonly treated with positive airway pressure therapy. Positive airway pressure therapy is delivered via a tight-fitting mask with common side effects including: leak, ineffective treatment, residual sleep disordered breathing, eye irritation, nasal congestion, pressure ulcers and poor concordance with therapy. This systematic review and meta-analysis aimed to identify the effectiveness of current treatment strategies for managing side effects associated with positive airway pressure therapy. Five databases were searched and 10,809 articles were screened, with 36 articles included in the review. Studies investigated: dressings, nasal spray/douche, chin straps, heated humidification and interfaces. No intervention either improved or detrimentally affected: positive airway pressure concordance, Epworth Sleepiness Score, residual apnoea hypopnea index or interface leak. The review was limited by study heterogeneity, particularly for outcome measures. Additionally, patient demographics were not reported, making it difficult to apply the findings to a broad clinical population. This review highlights the paucity of evidence supporting treatment strategies to manage side effects of positive airway pressure therapy.

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Prevention of leakage due to mouth opening through applying an oral shield device (Sominpax™) during nasal CPAP therapy of patients with obstructive sleep apnea

Cited by 4 publications

References 31 publications

In search of a better CPAP interface: A network meta‐analysis comparing nasal masks, nasal pillows and oronasal masks

In search of a better CPAP interface: A network meta‐analysis comparing nasal masks, nasal pillows and oronasal masks

The Impact of Mouth-Taping in Mouth-Breathers with Mild Obstructive Sleep Apnea: A Preliminary Study

Current treatment strategies in managing side effects associated with domiciliary Positive Airway Pressure (PAP) therapy for patients with sleep disordered breathing: A systematic review and meta-analysis

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