Introduction
chronic disorder, hypopneas, fatigue, choking, airway obstruction, hypopnea, OSA, apnea, daytime sleepiness, Apnea, snoring, arousals, impaired cognition or cardiovascular events, OSAS, collaps, hypopnea inspiratory airflow
CHRONIC DISORDER, CHOKING, OBSTRUCTIVE SLEEP APNEA SYNDROME, AIRWAY OBSTRUCTION, COLLAPSE, EVENTS, EXCESSIVE SLEEPINESS
Obstructive sleep apnea syndrome (OSAS) is a common chronic disorder caused by repetitive pharyngeal collapse during sleep leading to complete or partial airway obstruction during inspiratory airflow. It is characterized by frequent reoccurrences of hypopneas and apneas resulting in strongly compromised blood oxygenation levels resulting in frequent arousals and disrupted sleep often causing excessive daytime sleepiness [OSAS diagnosis is based on the combined evaluation of clinical symptoms and objective sleep study findings. Cardinal symptoms include loud snoring or choking, frequent awakenings and excessive sleepiness. The gold standard to confirm the clinical suspicion of OSAS is cardiorespiratory polysomnography with its primary diagnostic parameter being the apnea–hypopnea index (AHI). Apnea is defined as the complete absence of inspiratory airflow, whereas during hypopnea inspiratory airflow is only reduced. OSAS is defined as five or more episodes of apnea or hypopnea per hour of sleep in association with clinical symptoms (e.g., excessive daytime sleepiness, fatigue, impaired cognition or cardiovascular events) or 15 or more obstructive apnea–hypopnea events per hour of sleep regardless of any associated symptoms. Polysomnography is not only limited to OSAS diagnosis. It also proves to be a useful instrument in assessing severity and guiding therapeutic intervention [The therapeutic spectrum includes behavioral, conservative and surgical treatment options. Continuous positive airway pressure (CPAP) represents the treatment of choice in most patients suffering from OSAS [In the latter, for example, there is the possibility of Barbed reposition pharyngoplasty or Expansion Sphincter Pharyngoplasty. In case of palatal collaps the outcomes in both procedures appear to be comparable in the improvement of OSA and are considered safe procedures [Conservative treatment approaches include oral appliances, such as mandibular protrusion splints and palatal stenting devices. While the effectiveness of mandibular protrusion splints has been thoroughly examined in recent years, scientific evidence for palatal stenting devices is rather scarce [This study presents the first controlled and randomized clinical trial to examine the effectiveness of the Ronch®AP palatal device in treating OSAS patients with CPAP intolerance.