Search Our Scientific Publications & Authors

Medicina (Kaunas) 2021 Apr 1;57(4). Epub 2021 Apr 1.

Clinic of Pneumology and Allergology, Center for Sleep Medicine and Respiratory Care, Institute for Pneumology at the University Witten/Herdecke, 42699 Solingen, Germany.

Obstructive sleep apnea (OSA) syndrome is a multi-factorial disorder. Recently identified pathophysiological contributing factors include airway collapsibility, poor pharyngeal muscle responsiveness, a low arousal threshold, and a high loop gain. Understanding the pathophysiology is of pivotal importance to select the most effective treatment option. Read More

BMC Anesthesiol 2021 Apr 27;21(1):132. Epub 2021 Apr 27.

270 Department of Anesthesiology, Faculty of Medicine, Ramathibodi hospital, Mahidol University, Rama VI road, Phayathai, Ratchatewi, Bangkok, 10400, Thailand.

Background: Undiagnosed obstructive sleep apnea (OSA) is associated with adverse perioperative outcomes. The STOP-Bang questionnaire is a validated screening tool for OSA. However, its precision may vary among different populations. Read More

Eur Arch Otorhinolaryngol 2021 Apr 22. Epub 2021 Apr 22.

Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.

Purpose: To assess predictors of success and failure of an updated lateral pharyngoplasty as an independent procedure in treating obstructive sleep apnea with CPAP failures.

Methods: Forty-six patients with known OSAS who were resistant to CPAP or failures were included. BMI, Stop-Bang score, and sleep study data were recorded before and after the updated Cahali pharyngoplasty procedure. Read More

Nat Commun 2021 04 13;12(1):2205. Epub 2021 Apr 13.

Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

Parents frequently report behavioral problems among children who snore. Our understanding of the relationship between symptoms of obstructive sleep disordered breathing (oSDB) and childhood behavioral problems associated with brain structural alterations is limited. Here, we examine the associations between oSDB symptoms, behavioral measures such as inattention, and brain morphometry in the Adolescent Brain Cognitive Development (ABCD) study comprising 10,140 preadolescents. Read More

J Clin Sleep Med 2021 Apr 12. Epub 2021 Apr 12.

Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Study Objectives: The aim of the study was to inspect acoustic properties and sleep characteristics of pre-apneic snoring sound. The feasibility of forecasting upcoming respiratory events by snoring sound was also investigated.

Methods: Participants with habitual snoring or heavy breathing sound during sleep were recruited consecutively. Read More

Sleep Breath 2021 Apr 10. Epub 2021 Apr 10.

Neuro-Sono Sleep Center, Neurology Department, Unifesp, São Paulo, Brazil.

Aim: There are no studies comparing tests performed at home with those carried out in the laboratory, using the same device. The only studies that have been performed have compared the device used at home with the standard polygraph used in the laboratory. The purpose of this study was therefore to verify the accuracy of the home diagnosis of obstructive sleep apnea syndrome (OSAS) via unassisted type 2 portable polysomnography, compared with polysomnography using the same equipment in a sleep laboratory. Read More

J Perianesth Nurs 2021 Mar 19. Epub 2021 Mar 19.

Inova Fairfax Medical Center, Pediatric Surgery, Inova Health System, Falls Church, VA.

Purpose: This study was undertaken to select an appropriate tool to predict risk of obstructive sleep apnea (OSA) among pediatric patients in the preoperative setting.

Design/methods: A retrospective chart review and a survey of nursing staff to compare two tools that were determined to be valid in assessing risk of OSA and postanesthesia complications in pediatric patients aged 6 months to 18 years was conducted. About 300 pediatric patients presenting for elective surgery were screened for OSA using STBUR (Snoring, Trouble Breathing during sleep, struggling to Breathe during Sleep, and waking UnRefreshed) and ST(1)OP-BANG (Snoring, Tonsillar hypertrophy, sleep Obstruction, BMI, Age, Neuromuscular disorders, and Genetic/congenital deformities) concurrently. Read More

HNO 2021 Apr 17;69(4):325-334. Epub 2021 Mar 17.

Hals‑, Nasen‑, Ohrenklinik und Poliklinik und Kopf-Hals-Chirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.

Pediatric obstructive sleep apnea syndrome (OSAS) has a high prevalence in the general population. Risk factors are adenotonsillar hyperplasia, preterm birth, obesity, and craniofacial dysmorphia. A special feature of pediatric OSAS is that it can manifest in behavioral problems. Read More

Anesth Analg 2021 Mar 10. Epub 2021 Mar 10.

Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.

Background: Obstructive sleep apnea (OSA) has been found to be associated with difficult airway, although there is a paucity of prospective studies investigating thresholds of OSA severity with difficult airway outcomes. The aim of this study was to examine the association between OSA and difficult intubation or difficult mask ventilation. We also explored the utility of the Snoring, Tiredness, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference, and Gender (STOP-Bang) score for difficult airway prediction. Read More

Auris Nasus Larynx 2021 Mar 7. Epub 2021 Mar 7.

Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address:

Objective: The overnight rostral fluid shift from the lower limbs is one of the causes of obstructive sleep apnea (OSA). Compression stockings (CS) prevent lower limb fluid retention and have been reported to decrease nighttime fluid shift. The aim of this study is to evaluate the effect of CS on fluid shift and the severity of OSA. Read More

Int J Environ Res Public Health 2021 02 20;18(4). Epub 2021 Feb 20.

ENT Unit, "V.Fazzi" Hospital, 73100 ASL Lecce, Italy.

To analyze the middle latency auditory evoked potential index (MLAEPi), compared to the standard bispectral index (BIS), as a method for evaluating the sedation level in drug-induced sleep endoscopy (DISE). In this controlled clinical study on a sample of 99 obstructive sleep apnea (OSA) or snoring patients, we compared the MLAEPi with the BIS after propofol infusion during the standard DISE technique in order to define the MLAEPi values within the observational window of the procedure. The DISE procedure was divided into eight steps, and we collected both MLAEPi and BIS data values from the same patient in every step. Read More

Clin Oral Investig 2021 Mar 1. Epub 2021 Mar 1.

INSERM U1063, SOPAM, Angers University, F-49045, Angers, France.

Objectives: Mandibular advancement device (MAD) therapy is the most commonly used second-line treatment for obstructive sleep apnea (OSA), but MAD may be ineffective in a subgroup of patients. We describe the use of a trial of a titratable thermoplastic MAD to predict treatment outcomes with a custom-made MAD.

Materials And Methods: Patients treated with a thermoplastic MAD as a trial before custom-made MAD manufacturing were included in the study. Read More

Sleep Breath 2021 Feb 18. Epub 2021 Feb 18.

Department of Otolaryngology-Head and Neck Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshanerlu Street, Yuexiu District, Guangzhou, China.

Purpose: This study aimed to investigate pharyngeal paraesthesia symptoms in patients with obstructive sleep apnoea (OSA).

Material And Methods: Patients with snoring and suspected OSA as well as age-matched controls were recruited. All participants underwent nocturnal polysomnography (PSG) and pharyngeal paraesthesia assessment using the Glasgow-Edinburgh throat scale (GETS). Read More

Sleep Med 2021 Apr 22;80:77-85. Epub 2021 Jan 22.

Department of Women's and Children's Health, University of Otago, PO Box 56, Dunedin, New Zealand. Electronic address:

Objectives: The main objective of this study was to explore the feasibility and treatment sensitivity of measures of preschool oral language and emergent literacy and numeracy for assessing developing skills of preschool children with sleep disordered breathing (SDB) in New Zealand following adenotonsillectomy.

Methods: Eight preschool children aged 3 years 1 month-4 years 5 months were recruited from a surgical waiting list and matched to controls for age (±3 months) and sex. Tasks designed to be sensitive to growth in oral language and emergent literacy and numeracy were reviewed for contextual fit, adapted as necessary for the New Zealand context, and administered before surgery (baseline), three months post-surgery, and at a seven-month follow-up alongside other measures. Read More

Sleep Breath 2021 Feb 10. Epub 2021 Feb 10.

Department of Ear Nose and Throat and Head and Neck Surgery, Aksaray University Faculty of Medicine, 68100, Aksaray, Turkey.

Purpose: The aim of this study was to analyze both short-term and long-term results of the expansion sphincter pharyngoplasty surgery, which is commonly used in obstructive sleep apnea syndrome (OSAS) and to compare it with objective and subjective methods.

Methods: Patients who underwent expansion sphincter pharyngoplasty were included in the study. Polysomnography at postoperative sixth-month, Epworth Sleepiness Scale, and visual analog score of snoring (VAS) were used to assess short-term results. Read More

J Neurosurg Pediatr 2021 Jan 29:1-7. Epub 2021 Jan 29.

1Department of Clinical Neurosciences, Alberta Children's Hospital, University of Calgary.

Objective: Chiari 1.5 malformation is a subgroup of the Chiari malformation in which tonsillar descent into the foramen magnum is accompanied by brainstem descent. No data exist on whether operative decompression in patients with Chiari 1. Read More

Sleep Med 2021 Feb 10;78:193-201. Epub 2020 Nov 10.

Department of Respiratory Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, PR China. Electronic address:

Objective: The efficacy and safety of montelukast in children with obstructive sleep apnea (OSA) remain controversial. Therefore, the aims of this systemic review and meta-analysis are to verify this issue and further provide reference for clinical practice.

Methods: Seven databases were searched for randomized controlled trials (RCTs) up to September 30, 2019. Read More

Laryngoscope 2021 01 24;131(1):E307-E313. Epub 2020 Jul 24.

Department of Otorhinolaryngology, Institute of Surgical Science, Uppsala University, Uppsala, Sweden.

Objective: To investigate whether modified uvulopalatopharyngoplasty (UPPP) for treatment of obstructive sleep apnea (OSA) remained effective after 8 years.

Methods: Prospective intervention study. Sixty-five patients with OSA were offered re-evaluation with polysomnography and the Epworth Sleepiness Scale (ESS) 8 years after UPPP. Read More

Eur Arch Otorhinolaryngol 2021 Mar 2;278(3):901-909. Epub 2021 Jan 2.

Phoniatric Unit, Otorhinolaryngology-Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Purpose: To evaluate differential surgical interventions for obstructive sleep apnea (OSA) patients with single-level retropalatal based on the preoperative topographical diagnosis using nasoendoscopy with Müller's maneuver during supine position (MM-P).

Subjects And Methods: This case series included adult patients with OSA who showed a predominant single-level retropalatal collapse on MM-P. An anteroposterior pattern of collapse was managed by an anterior advancement procedure, while a transverse pattern of collapse was managed by lateral/anterolateral advancement procedures (double suspension sutures). Read More

J Biol Regul Homeost Agents 2020 Sep-Oct;34(5 Suppl. 3):123-126. Technology in Medicine

Integrated Sleep Surgery Team UCBM - Unit of Otolaryngology - Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy.

After the first experiences with the Barbed Sutures (BS) in sleep surgery, we present the Modular Barbed Anterior Pharyngoplasty (M.B.A. Read More

Nat Sci Sleep 2020 14;12:1173-1179. Epub 2020 Dec 14.

Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.

Dental sleep medicine traditionally focuses on sleep-related breathing disorders, such as snoring and obstructive sleep apnea. However, everyday practice shows that also other sleep disorders touch on dentistry, including sleep-related orofacial pain, xerostomia, hypersalivation, gastroesophageal reflux disease and bruxism. A new definition, which covers all the diagnostic and treatment aspects of these disorders, has therefore been formulated for dental sleep medicine. Read More

J Oral Biol Craniofac Res 2021 Jan-Mar;11(1):5-8. Epub 2020 Nov 19.

BBD Dental University, Lucknow, India.

Background: Alar collapse is known to aggravate snoring-severity and possibly the severity of obstructive sleep apnoea. Various surgical techniques, implants and commercial mechanical/prosthetic nasal alar dilators are evident in literature.

Material And Methods: A malleable wire prosthesis at 'no' manufacturing cost is custom designed through computer modelling and animation and thereafter tested for its efficacy in 20 normal subjects as per visual analog scale along with its correlation with patient-profiles. Read More

Arq Neuropsiquiatr 2020 12;78(12):783-788

Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Pulmonology Istanbul, Turkey.

Objective: Uric acid has been shown to be related to the severity of obstructive sleep apnoea syndrome (OSAS) in adults. We assessed the role of uric acid in OSAS in a cohort of older patients.

Methods: A total of 164 patients aged >65 years, admitted to our sleep laboratory between January 1st, 2016 and July 1st, 2018 with a complaint of snoring, underwent overnight polysomnography and were retrospectively evaluated. Read More

Sleep Med Rev 2021 Apr 29;56:101407. Epub 2020 Nov 29.

Special Care in Dentistry, Oral Health Sciences, Ghent University Hospital, Gent, Belgium; Department of Oral Health Sciences ORHE, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Educational Sciences EDWE-LOCI, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium; Department of Materials, Textiles and Chemical Engineering, Faculty of Engineering and Architecture, Ghent University, Belgium.

The aim of this review was to systematically evaluate the available scientific evidence on the benefit of mandibular advancement devices (MADs) in the treatment of primary snoring (PS). From 905 initially identified articles, 18 were selected. Papers that provided indirect information regarding obstructive sleep apnea syndrome (OSAS) and/or sleep breathing disorders (SBD) were included. Read More

Iran J Otorhinolaryngol 2020 Nov;32(113):349-357

Department of Otolaryngology, Al-Yarmouk Teaching Hospital, Baghdad, Iraq.

Introduction: Simple Snoring is low frequency sound without obstructive sleep apnea, produced mainly from vibration of the upper airway wall in the soft palate; it can be bothersome and may causes social problems. So the aim of this study is an attempt for relieving simple snoring though, stiffening the soft palate via transoral diode laser palatoplasty.

Materials And Methods: Forty six adult patients with socially troublesome snoring were recruited in this stuy. Read More

Arch Med Sci 2020 3;16(6):1346-1352. Epub 2020 Aug 3.

Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.

Introduction: Obstructive sleep apnea (OSA) and endothelial dysfunction are associated with cardiovascular risk factors and the development of atherosclerosis. Endocan is a marker of endothelial dysfunction, while obstructive sleep apnea is one of the causes of endothelial dysfunction. In this study, we investigated the relationship between endocan and obstructive sleep apnea severity. Read More

Clin Exp Otorhinolaryngol 2020 Nov 11. Epub 2020 Nov 11.

Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.

Objectives: The paired microbiome of adenoids and tonsils in pediatric patients with snoring has rarely been reported, and its correlation with clinical characteristics has not been evaluated till date. The aim of this study was to identify the adenotonsillar microbiome and determine its correlation with the subjective symptoms of pediatric patients with snoring and with regional mucosal immune molecules.

Methods: Twenty-four children, who underwent tonsillectomy with adenoidectomy owing to snoring, were enrolled in a cross-sectional study conducted between August 2017 and December 2018. Read More

J Biol Regul Homeost Agents 2020 Sep-Oct;34(5):1941-1948

Department of Head, Neck and Sense Organs, "Fondazione Policlinico A. Gemelli", IRCCS, Catholic University of Sacred Heart, Rome, Italy.

Int J Pediatr Otorhinolaryngol 2020 Nov 12;138:110380. Epub 2020 Sep 12.

Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, People's Republic of China. Electronic address:

Objectives: We assessed the influence of allergic rhinitis (AR) on sleep disordered breathing (SDB) in children with adenotonsillar hypertrophy (ATH), and compared sleep quality and polysomnographic data in habitually snoring children with or without AR.

Methods: Children with snoring resulting from adenoid/tonsils hypertrophy were recruited between Jan 1st, 2018 and Jun 30th, 2018. The exclusion criteria were congenital disorders, metabolic disorders, neurological disorders and pulmonary diseases, such as, asthma etc. Read More

Sleep Breath 2020 Oct 24. Epub 2020 Oct 24.

Department of Otorhinolaryngology Head and Neck surgery, Sint Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands.

Purpose: To evaluate the performance of the NoSAS (neck, obesity, snoring, age, sex) score, the STOP-Bang (snoring, tiredness, observed apneas, blood pressure, body mass index, age, neck circumference, gender) questionnaire, and the Epworth sleepiness score (ESS) as a screening tool for obstructive sleep apnea (OSA) severity based on the apnea-hypopnea index (AHI) and the oxygen desaturation index (ODI).

Methods: Data from 235 patients who were monitored by ambulant polysomnography (PSG) were retrospectively analyzed. OSA severity was classified based on the AHI; similar classification categories were made based on the ODI. Read More