title: [Therapeutic alternatives to continuous positive airway pressure for obstructive sleep apnea-hypopnea syndrome].
abstract: Oral appliance therapy (OAT) is the main therapeutic alternative to continuous positive airway pressure (CPAP). OAT has been recommended as an appropriate first-line treatment option for moderate obstructive sleep apnea-hypopnea syndrome (OSAHS) in patients without severe cardiovascular comorbidity. The lower efficacy of OAT in reducing sleep-disordered breathing could be offset by a higher compliance relative to CPAP, resulting in similar health outcomes in terms of sleepiness, neurobehavioral functioning, quality of life and blood pressure. Electrical stimulation of the hypoglossal nerve is a promising treatment approach for moderate to severe OSAHS. Avoiding the supine position during sleep and reducing the overnight rostral fluid shift from the legs to the neck can also achieve a partial improvement of sleep-disordered breathing. There are currently no medications to treat OSAHS effectively. At least fifty percent of OSAHS patients are affected by central obesity and related metabolic disorders. To date, there is no evidence that treating OSAHS may improve comorbid metabolic disorders. Weight-loss intervention is a central component of the strategies used to improve the cardiovascular risk-factor profile in patients with OSAHS and obesity.
authors.affiliation: CHU, département de pneumologie, 4, rue Larrey, 49033 Angers cedex 9, France; Université Bretagne-Loire, Inserm U1063, Angers, France. Electronic address: frgagnadoux@chu-angers.fr.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Gagnadoux
authors.affiliation: CHU, département de pneumologie, 4, rue Larrey, 49033 Angers cedex 9, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Jouvenot
authors.affiliation: CHU, département de pneumologie, 4, rue Larrey, 49033 Angers cedex 9, France; Université Bretagne-Loire, Inserm U1063, Angers, France.
authors.forename: Nicole
authors.initials: N
authors.lastname: Meslier
authors.affiliation: CHU, département de pneumologie, 4, rue Larrey, 49033 Angers cedex 9, France; Université Bretagne-Loire, Inserm U1063, Angers, France.
authors.forename: Pascaline
authors.initials: P
authors.lastname: Priou
authors.affiliation: CHU, département de pneumologie, 4, rue Larrey, 49033 Angers cedex 9, France; Université Bretagne-Loire, Inserm U1063, Angers, France.
authors.forename: Wocjiech
authors.initials: W
authors.lastname: Trzepizur
mesh_terms: D004599:Electric Stimulation Therapy; D006801:Humans; D007002:Hypoglossal Nerve; D019186:Mandibular Advancement; D056128:Obesity, Abdominal / Q000150:complications / Q000628:therapy; D017090:Occlusal Splints; D020181:Sleep Apnea, Obstructive / Q000209:etiology / Q000628:therapy*; D015431:Weight Loss