Pilot Study of Oral Negative Pressure Therapy for Obstructive Sleep Apnea-Hypopnea Syndrome

Abstract

Background: Although the continuous positive airway pressure is the gold standard therapy for patients with moderate to severe obstructive sleep apnea-hypopnea syndrome (OSAHS), there are several treatment options such as mandibular advancement devices, tongue-retaining devices, and nasal airway stent devices. Recently, newly developed intraoral pressure gradient therapy system, iNAP ® Sleep Therapy System, was introduced as an alternative treatment for OSAHS patients.

Novel Intraoral Negative Airway Pressure in Drug-Induced Sleep Endoscopy with Target-Controlled Infusion

“…One study suggested the use of the iNAP device for the treatment of mild-to-moderate OSA. 11 In an investigation of the therapeutic spectrum of the iNAP device, Hung et al (2020) reported that the best candidates for its use are individuals without obesity and with a baseline AHI between 5 and 50 events/h. 12 The discrepancies in our study results indicated that neither the AHI nor BMI can be a favorable predictor.…”

“…8 Oral pressure therapy (OPT) is an alternative treatment modality for patients with poor compliance to CPAP. [9][10][11][12][13] Nigam et al 10 reported that the OPT success rate (defined as a reduction of ≥50% from the baseline apnea-hypopnea index [AHI] and a post-OPT treatment residual AHI of ≤10) varies between 25% and 37%. However, the success rate does not correlate with OSA severity or the body mass index (BMI); 10,12 therefore, identifying responders and nonresponders to OPT treatment necessitates the establishment and comprehensive examination of predictors.…”

“…Intermittent negative airway pressure (iNAP) therapy (Figure 1), the latest form of OPT, is characterized by a lower oral tissue discomfort rate and possibly more favorable compliance. [11][12][13] By providing intermittent negative pressure to the oral cavity, the iNAP device moves both the soft palate and tongue in an anterior direction, thereby increasing retropalatal and retroglossal areas and reducing airway obstruction during sleep. 13 The device is battery powered, and the air flow is designed to stop when the targeted negative oral pressure is achieved and restart again only when air flow is required to prevent a decrease in target pressure.…”