title: The efficacy of a chinstrap in treating sleep disordered breathing and snoring.
abstract: OBJECTIVE
  A previously published case report suggested that a chinstrap alone might improve obstructive sleep apnea (OSA). We conducted this study to determine whether a chinstrap was a feasible alternative to continuous positive airway pressure (CPAP) in patients with OSA.
  
  
  METHODS
  26 adult patients with OSA (apnea-hypopnea index [AHI] > 5/h on diagnostic polysomnogram [PSG]) underwent a modified split-night PSG, using only a chinstrap for the first 2 hours of sleep, followed by CPAP titration for the remainder of the night. Improvements in AHI, arterial oxygen saturation (SpO2), and snoring with chinstrap use were compared to results with optimal CPAP pressures.
  
  
  RESULTS
  There was no significant difference between the diagnostic PSG and the chinstrap portion of the split-night PSG in the following parameters: general AHI (median [IQR] 16.0/h [9.7-26.0] vs. 25.9/h [10.7-42.7]), SpO2 nadir (84.0% [80.5-87.5] vs. 87.0 [84.0-88.5]), AHI in REM sleep (26.7/h [16.8-43.7] vs. 42.4/h [21.3-57.7]), AHI in supine sleep (24.9/h [11.9-51.5] vs. 29.8/h [11.7-55.5]), snoring index (253.2/h [147.5-353.1] vs. 180.0/h [9.8-393.3]) or subjective snoring scale (3.0 [0.8-3.0] vs. 2.5 [0.4-3.0]). The AHI and SpO2 nadir in the 13 patients with mild OSA also did not improve with chinstrap use (9.6/h [8.1-12.2] vs. 10.6/h [6.8-35.4] and 87.0% [83.0-90.0] vs. 88.0% [87.0-89.0]). All these parameters showed significant improvement with optimal CPAP titration (p < 0.05).
  
  
  CONCLUSIONS
  A chinstrap alone is not an effective treatment for OSA. It does not improve sleep disordered breathing, even in mild OSA, nor does it improve the AHI in REM sleep or supine sleep. It is also ineffective in improving snoring.
authors.affiliation: NJ Neuroscience Institute at JFK Medical Center/Seton Hall University, Edison NJ;
authors.forename: Sushanth
authors.initials: S
authors.lastname: Bhat
authors.affiliation: NJ Neuroscience Institute at JFK Medical Center/Seton Hall University, Edison NJ;
authors.forename: Neola
authors.initials: N
authors.lastname: Gushway-Henry
authors.affiliation: NJ Neuroscience Institute at JFK Medical Center/Seton Hall University, Edison NJ;
authors.forename: Peter G
authors.initials: PG
authors.lastname: Polos
authors.affiliation: Seton Hall University School of Health and Medical Sciences, South Orange, NJ;
authors.forename: Vincent A
authors.initials: VA
authors.lastname: DeBari
authors.affiliation: JFK Medical Center, Edison, NJ;
authors.forename: Sandeep
authors.initials: S
authors.lastname: Riar
authors.affiliation: NJ Neuroscience Institute at JFK Medical Center/Seton Hall University, Edison NJ;
authors.forename: Divya
authors.initials: D
authors.lastname: Gupta
authors.affiliation: Ochsner Health Systems, New Orleans, LA;
authors.forename: Liudmila
authors.initials: L
authors.lastname: Lysenko
authors.affiliation: NJ Neuroscience Institute at JFK Medical Center/Seton Hall University, Edison NJ;
authors.forename: Disha
authors.initials: D
authors.lastname: Patel
authors.affiliation: Hackensack University Medical Center, Hackensack NJ.
authors.forename: Justin
authors.initials: J
authors.lastname: Pi
authors.affiliation: NJ Neuroscience Institute at JFK Medical Center/Seton Hall University, Edison NJ;
authors.forename: Sudhansu
authors.initials: S
authors.lastname: Chokroverty
mesh_terms: D000328:Adult; D002680:Chin; D004864:Equipment and Supplies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012891:Sleep Apnea Syndromes / Q000628:therapy*; D012913:Snoring / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: REM OSA; alternatives to CPAP; chinstrap; modified split-night polysomnography; obstructive sleep apnea; polysomnography; positional OSA; snoring