Objective

Due to the complexity of obstructive sleep apnea syndrome (OSAS), engaging patients in the right treatment poses a constant challenge. A novel oral pressure therapy device, the intermittent negative air pressure Sleep Therapy System (iNAP), has proven to ameliorate respiratory events for OSAS patients. However, the mode of action and the characteristics of its responders are not yet fully understood. Therefore, we have first disclosed the mechanism and provided systemic models to predict the treatment response.

Methods

Series of imaging studies were carried out to differentiate the anatomical features of iNAP responders versus non-responders. Compatible electroencephalography was used to evaluate sleep status during magnetic resonance imaging (MRI) assessments.

Results

The upper airway volume was statistically widened under the iNAP treatment while patients were naturally asleep (p < 0.05). Negative predictors included several parameters related to oral-tissue redundancy, enlarged middle pharyngeal space, and longer distance of hyoidale to mandibular plane. Positive predictors included larger angulation of sella-articulate-gonion, longer distance of anterior nasal spine to posterior nasal spine, and elongated tongue, which could correspond to the fact that the iNAP had a greater ability to widen the retropalatal region. Furthermore, algorithms developed by these predictors were built to predict treatment response.

Conclusions

We were able to confirm the effect of the iNAP in widening the upper airway. Anatomic features that can be visually observed or obtained through X-ray films, accompanied with the resulting algorithms, were provided to facilitate physicians' ability to predict patients' treatment response to the iNAP with greater sensitivity and efficiency.

中文翻译：

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建立一个模型以精确地定位新型间歇性负气压设备的响应者-带有机构定义。

目的

由于阻塞性睡眠呼吸暂停综合症（OSAS）的复杂性，使患者接受正确的治疗一直是一个挑战。一种新型的口腔压力治疗设备，间歇性负气压睡眠治疗系统（iNAP），已被证明可以改善OSAS患者的呼吸事件。但是，作用方式及其响应者的特征尚未完全了解。因此，我们首先公开了该机制并提供了系统模型来预测治疗反应。

方法

进行了一系列成像研究，以区分iNAP反应者和非反应者的解剖特征。兼容的脑电图用于评估磁共振成像（MRI）评估期间的睡眠状态。

结果

在患者自然入睡的情况下，在iNAP治疗下，上呼吸道容积在统计学上变宽（p <0.05）。阴性预测因子包括与口腔组织冗余度，咽中间隙增大和舌骨距下颌骨距离更长有关的几个参数。积极的预测因素包括蝶鞍关节角度更大，前鼻梁到后鼻梁的距离更长以及舌头拉长，这可能对应于iNAP具有更大的后pal区域加宽能力。此外，建立了由这些预测变量开发的算法来预测治疗反应。

结论

我们能够确认iNAP在加宽上呼吸道方面的作用。提供了可以在视觉上观察到的或通过X射线胶片获得的解剖特征以及所产生的算法，以帮助医生以更高的灵敏度和效率来预测患者对iNAP的治疗反应。