Effect of nocturnal retroflection of the neck on obstructive sleep apnea
The objective of this project is to investigatea new treatment method for preventing airway collapse during sleepin patients with obstructive sleep apnea syndrome (OSAS). Furthermore, the objective of this project is to investigate and evaluate validity of sleep questionnaires to identify patients with OSAS in a primary care setting.
Continuous positive airway pressure (CPAP) is effective treatment but meets with compliance problems, whereas other available treatments have suboptimal efficacy. An optimal retroflection of the neck with a cervical collar (CC) which allows adjustment of the elevation level could possibly provide a freer airway during sleep, leading tofewer apneas/hypopneas, improved oxygenation and reduced daytime sleepiness. It is also conceivable that the CC and mandibular advancement therapy (MAD) mighthave synergic effects. In a cross-over randomized pilot study, we compared the effect of MAD with the effect of cervical collar and MAD in combination. The study showed significant effects on AHI (apnea-hypopnea index) reduction in patients with severe sleep apnea with combination therapy. In the next two groups randomized study we aim to investigate theeffect of CC and lifestyle advice in patients with moderate sleep apnea syndrome. Allpatients will receive lifestyle advice and will fill in standardized questionnaire before and after each treatment. Full-night polygraphy records occur at the beginning of the study and one month after start of treatment. The patients who continue their treatment will be followed up after one year with new full-night polygraphy registration including standardized questionnaires