Development and the Effectiveness of a Nasal Breathing Stimulator Combined with an Oral Appliance for Treating Obstructive Sleep Apnea

Abstract

Objective: Many obstructive sleep apnea (OSA) patients have nasal obstruction. Further, most patients discontinue wearing an oral appliance (OA) for improving respiration due to nasal obstruction. We aimed to develop a nasal breathing stimulator (NBS) for use in combination with an OA to promote nasal breathing. Methods: Thirteen OSA patients wore a NBS, Max -Air Nose Corns ® , Mute with hole ® , which expands the nasal cavity from the inside, and Breathe Right ® , which expands the nasal cavity from the outside, and compared the resultant changes in respiratory measures with those when a device was not used. The inspiratory flow rate (peak nasal inspiratory flow: PNIF) and visual analogue scale (VAS) scores were measured under five conditions. Furthermore, PNIF was measured under four conditions: OA ( -) NBS ( -) , OA (+) NBS ( -) , OA ( -) NBS (+) , and OA (+) NBS (+) , and a sleep test was performed.Results: PNIF was significantly higher when wearing an NBS compared with the other four devices (p < 0.001) . In addition, PNIF was significantly higher in OA (+) NBS (+) than that in the other three conditions (p < 0.001) , and OA (+) NBS (+) improved the respiratory disturbance index (p < 0.001) , lowest SpO 2 ( p < 0.001) , and Epworth sleepiness scale (ESS) score (p < 0.001) on the sleep test.Discussion: Wearing the NBS improved breathing in patients who did not benefit from OA treatment alone and in those who discontinued OA use due to nasal obstruction.