WHAT'S NEW?

Web Changes

This is where we'll announce the most recent additions to our web site involved with Sleep and Sleep Disorders as well as any relevant news. If you've visited us before and would like to know what's changed, take a look here first.

Come visit our new pages on Snoring and Sleep Apnea!

Airway Examples
Evolution of Snoring if Left Untreated
Effects of Treatment
More on Dental Appliances
3 Basic Kinds of Dental Appliances
Mandibular Advancement
Jaw Thrust
Key Anatomic Relations in Mandibular Advancement
Effect of Increasing the Vertical Opening with the Mandible Advanced
CPAP vs. Mandibular Advancement
Mandibular Advancement with a Dental Appliance and the Upper Airway
Further Information on CPAP
New Developments in CPAP
The Harmful Effects of LAUP
Effects of LAUP on Different Kinds of Snorers
Structures Seen During Nasopharyngoscopy
Dynamic Nasopharyngoscopy Example
Stanford Method for Predicting OSA

This web site will be revised again in July, 1998.  Come back to see our new additions!

Using Radio Frequency Waves to Treat Snoring and OSA

Somnus Medical Technologies proposes to use radio frequency (rf) waves to reshape the airways of patients with snoring and/or obstructive sleep apnea. Radio frequency waves have been used to treat tumors in the lung, liver, kidneys, prostate and female pelvic organs. The delivery mechanism consists of a needle containing the rf source that is inserted into the target tissue. A focusing antenna (that looks like the frame of an umbrella) with a diameter of several centimeters is deployed through the same needle into the target tissue. Rf pulses are then used to heat and kill the tissue. The irradiated volume is measured in cubic centimeters.

In order for this technology to be used in the upper airway, the irradiated volume would have to be reduced to cubic millimeters. Otherwise, there would be severe collateral damage to nearby structures such as nerves and blood vessels.

At present, this application of rf technology is experimental. In order for it to be widely used, the following questions must be addressed:

• What are the effects of this procedure on swallowing and speech?
• What is the durability of the surgical outcome?
• How can one determine which patients are appropriate for this procedure?
• Can it be used by a surgeon who possesses only ordinary skill?
• How can one determine which structures to target for treatment in a given patient?

An animal model using the English bulldog would be extremely valuable in determining the effects of rf radiation on tissues in the upper airway.

The role of this technology in the management of snoring and sleep apnea remains to be defined.

Using a Pacemaker to Control the Tongue During Sleep

Research has shown that the muscles of the tongue become activated when a person takes a breath in. This helps to increase the size of the air passage. This reflex is blunted during sleep. A new and experimental treatment for OSA is to use a pacemaker to activate the tongue during sleep. The electrical impulses from the pacemaker are synchronized to the patient's breathing so that the tongue muscles are activated at the right moment in time to enlarge the airway.

This treatment has been used in small numbers of patients with Severe OSA and has enabled these patients to decrease the pressure of their CPAP to more comfortable levels.

The pacemakers, which are produced by Medtronics, cost ~ $7,000 each. This does not include the cost of surgery to implant the pacemaker. Accurate placement of the stimulating electrode is required in order for the device to work properly. Battery life will depend on how frequently the pacemaker is activated, and the strength of the electrical signal required to cause a contraction of the tongue.

This page was last revised on: December 27, 1999.