Related Experiment Video
Updated: Jul 18, 2025
07:54
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
19.8K
Sleep apnea multi-level surgery trial: long-term observational outcomes
Alison J Pinczel1, Charmaine M Woods2,3, Peter G Catcheside1
1Adelaide Institute for Sleep Health, FHMRI Sleep Health, Flinders University, Adelaide, SA, Australia.
Sleep
|August 22, 2023
Summary
Multi-level upper airway surgery significantly reduces obstructive sleep apnea (OSA) severity long-term. This surgical approach offers sustained improvement for patients with moderate-to-severe OSA who have not responded to other treatments.
Area of Science:
- Otolaryngology
- Sleep Medicine
- Surgical Innovation
Background:
- Obstructive sleep apnea (OSA) significantly impacts patient health and quality of life.
- Continuous positive airway pressure (CPAP) therapy is a common treatment, but adherence can be challenging.
- Multi-level upper airway surgery (SAMS trial) previously demonstrated short-term benefits for moderate-to-severe OSA patients failing CPAP.
Purpose of the Study:
- To evaluate the long-term effectiveness and durability of multi-level upper airway surgery for moderate-to-severe obstructive sleep apnea (OSA).
- To assess changes in primary outcomes (apnea-hypopnea index and Epworth sleepiness scale) and secondary outcomes from baseline to long-term follow-up.
- To compare long-term outcomes with initial 6-month results and evaluate adverse events.
Main Methods:
- A case series follow-up of patients from the SAMS randomized clinical trial who underwent multi-level upper airway surgery.
- Long-term reassessment (>2 years postoperatively) of primary outcomes: apnea-hypopnea index (AHI) and Epworth sleepiness scale (ESS).
- Statistical analysis using mixed-effects regression models to assess long-term effectiveness and interval changes; control group reassessed for subsequent surgery and outcomes.
Main Results:
- 75% of surgical participants (36/48) were reevaluated at a mean of 3.5 years post-surgery.
- Significant persistent improvements observed: AHI decreased from 41/h to 21/h (p < 0.001), and ESS decreased from 12.3 to 5.5 (p < 0.001).
- Secondary outcomes showed sustained improvement, with minor adverse events; control group showed increased rates of subsequent surgery.
Conclusions:
- Multi-level upper airway surgery provides a durable and effective treatment option for moderate-to-severe OSA in patients who have failed conventional therapies.
- The surgical benefits on OSA burden and daytime sleepiness are maintained over the long term.
- This surgical approach represents a valuable therapeutic strategy for improving long-term outcomes in refractory OSA patients.
Related Concept Videos
01:21Sleep Apnea
184
Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
The condition is more prevalent among...
184
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
16
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
16
02:07Blind Procedures
10.7K
Ideally, the people who observe and record the children’s behavior are unaware of who was assigned to the experimental or control group, in order to control for experimenter bias. Experimenter bias refers to the possibility that a researcher’s expectations might skew the results of the study. Remember, conducting an experiment requires a lot of planning, and the people involved in the research project have a vested interest in supporting their hypotheses. If the observers knew which...
10.7K