title: Examining the mechanism of action of a new device using oral pressure therapy for the treatment of obstructive sleep apnea.
abstract: OBJECTIVE
  The objective of this study was to explore the mechanism of action of the oral pressure therapy (OPT) device, a new treatment for sleep apnea.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Fifteen subjects with sleep apnea who had been successfully treated (responders) with the OPT device and 4 subjects who were not successfully treated (non-responders) with the OPT device.
  
  
  METHODS
  All subjects underwent a MRI (without the device, with the device in place without vacuum and with the device in place with vacuum) to examine the biomechanical changes associated with the OPT device.
  
  
  RESULTS
  Oral pressure therapy significantly (P = 0.002) increased the size of the retropalatal airway in both the lateral and anterior-posterior dimensions by moving the soft palate anteriorly and superiorly and the anterior-superior segment of the tongue forward, toward the teeth. The percentage and absolute increase in the cross-sectional area of the retropalatal region, the superior movement of the soft palate, and the anterior displacement of the tongue were significantly greater in the responders than in the non-responders. In responders, there were significant increases in the mean (P = 0.002), maximum (P = 0.0002), and minimum (P = 0.04) cross-sectional areas of the retropalatal region with the OPT device. However, in the retroglossal region, airway caliber decreased with the OPT device.
  
  
  CONCLUSIONS
  In those who responded to oral pressure therapy, it increased airway caliber in the retropalatal region by moving the soft palate anteriorly and superiorly and the anterior-superior segment of the tongue forward.
  
  
  BACKGROUND
  Schwab RJ, Kim C, Siegel L, Keenan BT, Black J, Farid-Moayer M, Podmore J, Vaska M. Examining the mechanism of action of a new device using oral pressure therapy for the treatment of obstructive sleep apnea.
authors: Division of Sleep Medicine, Pulmonary Allergy and Critical Care Division and Center for Sleep & Circadian Neurobiology, Philadelphia PA.
authors: Richard J
authors: RJ
authors: Schwab
authors: Division of Sleep Medicine, Pulmonary Allergy and Critical Care Division and Center for Sleep & Circadian Neurobiology, Philadelphia PA.
authors: C
authors: C
authors: Kim
authors: Stanford University School of Medicine, Stanford, CA ; ApniCure, Redwood City CA.
authors: Lawrence
authors: L
authors: Siegel
authors: Division of Sleep Medicine, Pulmonary Allergy and Critical Care Division and Center for Sleep & Circadian Neurobiology, Philadelphia PA.
authors: B T
authors: BT
authors: Keenan
authors: Stanford University School of Medicine, Stanford, CA.
authors: Jed
authors: J
authors: Black
authors: Peninsula Sleep Center, Burlingame, CA.
authors: Mehran
authors: M
authors: Farid-Moayer
authors: ApniCure, Redwood City CA.
authors: Jonathan
authors: J
authors: Podmore
authors: ApniCure, Redwood City CA.
authors: Matt
authors: M
authors: Vaska
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009068:Movement; D010160:Palate, Soft / Q000033:anatomy & histology / Q000503:physiopathology; D017286:Polysomnography; D011312:Pressure; D012137:Respiratory System / Q000503:physiopathology; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000628:therapy*; D014059:Tongue / Q000033:anatomy & histology / Q000503:physiopathology; D055815:Young Adult
keywords: MRI; oral pressure therapy; sleep apnea; upper airway imaging