A study on the tolerability and effectiveness of a nasal airway stent in the management of obstructive sleep apnea in our clinic
The Nastent® (Nastent, Inc., Tokyo) is a nasal airway stent (NAS) released in July 2014 for the management of obstructive sleep apnea syndrome (OSAS), but there are few reports on the tolerability and effectiveness of this NAS. The purpose of this study was to assess the tolerability and evaluate th...
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Published in | jibi to rinsho Vol. 67; no. 2; pp. 87 - 97 |
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Main Author | |
Format | Journal Article |
Language | Japanese |
Published |
JIBI TO RINSHO KAI
20.03.2021
耳鼻と臨床会 |
Subjects | |
Online Access | Get full text |
ISSN | 0447-7227 2185-1034 |
DOI | 10.11334/jibi.67.2_87 |
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Abstract | The Nastent® (Nastent, Inc., Tokyo) is a nasal airway stent (NAS) released in July 2014 for the management of obstructive sleep apnea syndrome (OSAS), but there are few reports on the tolerability and effectiveness of this NAS. The purpose of this study was to assess the tolerability and evaluate the effectiveness of using a NAS in OSAS management in our clinic. In this study, out-of-center sleep testing (OCST) using Watch-PAT® was performed with and without insertion of a NAS or OA (oral appliance). The testing revealed no marked difference in the sleeping time by the insertion or lack of a NAS or OA, and some patients were able to wear a NAS for a long period of time 17.4 ± 20.9 months (0.1 to 52 months), with significant improvements noted in the snoring index and lowest SpO2 (saturation of percutaneous oxygen) with a NAS. As a result, OSAS therapeutic approaches other than the NAS were selected for 6 (54.5%) subjects who wanted to use a NAS. In conclusion, the present study indicates that it is necessary to explain the possibility that the use of a NAS may not always achieve satisfactory results and we therefore recommend OCST with and without the insertion of a NAS. |
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AbstractList | The Nastent® (Nastent, Inc., Tokyo) is a nasal airway stent (NAS) released in July 2014 for the management of obstructive sleep apnea syndrome (OSAS), but there are few reports on the tolerability and effectiveness of this NAS. The purpose of this study was to assess the tolerability and evaluate the effectiveness of using a NAS in OSAS management in our clinic. In this study, out-of-center sleep testing (OCST) using Watch-PAT® was performed with and without insertion of a NAS or OA (oral appliance). The testing revealed no marked difference in the sleeping time by the insertion or lack of a NAS or OA, and some patients were able to wear a NAS for a long period of time 17.4 ± 20.9 months (0.1 to 52 months), with significant improvements noted in the snoring index and lowest SpO2 (saturation of percutaneous oxygen) with a NAS. As a result, OSAS therapeutic approaches other than the NAS were selected for 6 (54.5%) subjects who wanted to use a NAS. In conclusion, the present study indicates that it is necessary to explain the possibility that the use of a NAS may not always achieve satisfactory results and we therefore recommend OCST with and without the insertion of a NAS.
ナステント®(ナステント株式会社 東京都、以下 NAS)は 2014 年 7 月に発売されたが、その忍容性や、OSAS への効果についての報告は少ない。そこで当診療所での NAS の使用経験から、NAS の忍容性を評価し、OSAS への効果の検討を行った。本検討では簡易型睡眠検査機器である Watch-PAT®(Itamar Medical Caesarea, Israel)を用いて NAS またはマウスピース装用前後で睡眠検査を行い比較検討した。NAS 装用前後で睡眠時間の短縮はなく、一部の患者では長期に NAS 装用が可能であり、NAS 装用前後でいびき(%)と最低 SpO2値において有意な改善がみられた。重要な結果として、NAS 装用希望者中 6 例(54.5%)に NAS 以外の治療方針が選択された。結論として、NAS 装用を希望する患者には効果が得られない可能性を説明し、装用前後の効果確認を勧めることが必要と考えられた。 The Nastent® (Nastent, Inc., Tokyo) is a nasal airway stent (NAS) released in July 2014 for the management of obstructive sleep apnea syndrome (OSAS), but there are few reports on the tolerability and effectiveness of this NAS. The purpose of this study was to assess the tolerability and evaluate the effectiveness of using a NAS in OSAS management in our clinic. In this study, out-of-center sleep testing (OCST) using Watch-PAT® was performed with and without insertion of a NAS or OA (oral appliance). The testing revealed no marked difference in the sleeping time by the insertion or lack of a NAS or OA, and some patients were able to wear a NAS for a long period of time 17.4 ± 20.9 months (0.1 to 52 months), with significant improvements noted in the snoring index and lowest SpO2 (saturation of percutaneous oxygen) with a NAS. As a result, OSAS therapeutic approaches other than the NAS were selected for 6 (54.5%) subjects who wanted to use a NAS. In conclusion, the present study indicates that it is necessary to explain the possibility that the use of a NAS may not always achieve satisfactory results and we therefore recommend OCST with and without the insertion of a NAS. |
Author | MIYAJI, Hideaki |
Author_FL | 宮地 英彰 |
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DocumentTitle_FL | 当診療所におけるナステント®の忍容性の評価と閉塞性睡眠時無呼吸症候群(OSAS)への効果の検討 |
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References | 21) Yalamanchali S et al : Diagnosis of obstructive sleep apnea by peripheral arterial tonometry meta-analysis. JAMA Otolaryngol Head Neck Surg 139 : 1343-1350, 2013. 22) Camacho M et al : Inferior turbinate classification system, grades 1 to 4 − Development and validation study −. Laryngoscope 125 : 296-302, 2015. 26) Li S et al : The nasopharyngeal tube − A simple and effective tool to indicate the need for uvulopalatopharyngoplasty −. Laryngoscope 124 : 1023-1028, 2014. 23) 設楽 準 : 連載第 6 回睡眠検査 Q & A 「ウォッチパット」が在宅無呼吸評価に使われていますが,どのような仕組みでしょうか? また,睡眠ポリグラフ検査(PSG)と比較して,その精度はいかがでしょうか? 睡眠医療 12 : 599-602,2018 13) Afzelius LE et al : Sleep apnea syndrome − An alternative treatment to tracheostomy −. Laryngoscope 91 : 285-291, 1981. 10) 千葉伸太郎 : 睡眠関連呼吸障害に対する咽頭手術.口咽科 30 : 17-24,2017 20) Miyoshi T et al : Efficacy and tolerability of the nasal airway stent in the treatment of snoring. Clin Med Rev Case Rep 6 : 261, 2019. 27) 篠邊龍二郎 他 : 睡眠呼吸障害の診断・治療・医療連携ガイドライン.睡眠医療 2 : 271-278,2008 9) Powell N et al : A reversible uvulopalatal flap for snoring and sleep apnea syndrome. Sleep 19 : 593-599, 1996. 1) Young T et al : The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328 : 1230-1235, 1993. 24) Bajaj Y et al : Securing a nasopharyngeal airway. J Laryngol Otol 122 : 733-734, 2008. 2) Tanigawa T et al : Relationship between sleep-disordered breathing and blood pressure levels in community-based samples of japanese men. Hypertens Res 27 : 479-484, 2004. 6) Sasanabe R et al : Metabolic syndrome in Japanese patients with obstructive sleep apnea syndrome. Hypertens Res 29 : 315-322, 2006. 25) Stoneham MD : The nasopharyngeal airway. − Assessment of position by fibreoptic laryngoscopy. Anaesthesia 48 : 575-580, 1993. 16) Kumar AR et al : Nasopharyngeal airway stenting devices for obstructive sleep apnoea − A systematic review and meta-analysis −. J Laryngol Otol 129 : 2-10, 2015. 7) Young T et al : Sleep disordered breathing and mortality − Eighteen-year follow-up of the wisconsin sleep cohort −. Sleep 31 : 1071-1078, 2008. 11) Sarkhosh K et al : The impact of bariatric surgery on obstructive sleep apnea − A systematic review −. OBES SURG 23 : 414-423, 2013. 8) Weaver TE and Grunstein RR : Adherence to continuous positive airway pressure therapy − The challenge to effective treatment −. Proc Am Thoracic Soc 5 : 173-178, 2008. 19) Okuno K et al : The efficacy of nasal airway stent (Nastent) on obstructive sleep apnoea and prediction of treatment outcomes. J Oral Rehabil 46 : 51-57, 2019. 5) Aronsohn RS et al : Impact of untreated obstructive sleep apnea on glucose control in type 2 diabetes. AM J Respir Crit Care Med 181 : 507-513, 2010. 12) Walsh RE et al : Upper airway obstruction in obese patients with sleep disturbance and somnolence. Ann Intern Med 76 : 185-192, 1972. 17) 佐藤 誠 : Nasal airway stent (NAS) − 鼻腔挿入デバイス −.循環器内科 82 : 478-483,2017 3) Cui R et al : Associations of sleep-disordered breathing with excessive daytime sleepiness and blood pressure in Japanese women. Hypertens Res 31 : 501-506, 2008. 15) Nahmias JS and Karetzky MS : Treatment of the obstructive sleep apnea syndrome using a nasopharyngeal tube. Chest 94 : 1142-1147, 1988. 4) Somers VK et al : Sleep apnea and cardiovascular disease − An American Heart Association/American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health) −. Circulation 118 : 1080-1111, 2008. 14) Singh JR et al : The use of nasal trumpet in a traumatic brain injury patient with obstructive sleep apnea. PM&R 1 : 977-979, 2009. 18) Hirata Y and Satoh M : Pilot study of the nasal airway stent for the treatment on obstructive sleep apnea. J Sleep Disord Ther 4 : 207, 2015. |
References_xml | – reference: 16) Kumar AR et al : Nasopharyngeal airway stenting devices for obstructive sleep apnoea − A systematic review and meta-analysis −. J Laryngol Otol 129 : 2-10, 2015. – reference: 17) 佐藤 誠 : Nasal airway stent (NAS) − 鼻腔挿入デバイス −.循環器内科 82 : 478-483,2017. – reference: 4) Somers VK et al : Sleep apnea and cardiovascular disease − An American Heart Association/American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health) −. Circulation 118 : 1080-1111, 2008. – reference: 7) Young T et al : Sleep disordered breathing and mortality − Eighteen-year follow-up of the wisconsin sleep cohort −. Sleep 31 : 1071-1078, 2008. – reference: 3) Cui R et al : Associations of sleep-disordered breathing with excessive daytime sleepiness and blood pressure in Japanese women. Hypertens Res 31 : 501-506, 2008. – reference: 13) Afzelius LE et al : Sleep apnea syndrome − An alternative treatment to tracheostomy −. Laryngoscope 91 : 285-291, 1981. – reference: 11) Sarkhosh K et al : The impact of bariatric surgery on obstructive sleep apnea − A systematic review −. OBES SURG 23 : 414-423, 2013. – reference: 8) Weaver TE and Grunstein RR : Adherence to continuous positive airway pressure therapy − The challenge to effective treatment −. Proc Am Thoracic Soc 5 : 173-178, 2008. – reference: 19) Okuno K et al : The efficacy of nasal airway stent (Nastent) on obstructive sleep apnoea and prediction of treatment outcomes. J Oral Rehabil 46 : 51-57, 2019. – reference: 2) Tanigawa T et al : Relationship between sleep-disordered breathing and blood pressure levels in community-based samples of japanese men. Hypertens Res 27 : 479-484, 2004. – reference: 27) 篠邊龍二郎 他 : 睡眠呼吸障害の診断・治療・医療連携ガイドライン.睡眠医療 2 : 271-278,2008. – reference: 10) 千葉伸太郎 : 睡眠関連呼吸障害に対する咽頭手術.口咽科 30 : 17-24,2017. – reference: 21) Yalamanchali S et al : Diagnosis of obstructive sleep apnea by peripheral arterial tonometry meta-analysis. JAMA Otolaryngol Head Neck Surg 139 : 1343-1350, 2013. – reference: 23) 設楽 準 : 連載第 6 回睡眠検査 Q & A 「ウォッチパット」が在宅無呼吸評価に使われていますが,どのような仕組みでしょうか? また,睡眠ポリグラフ検査(PSG)と比較して,その精度はいかがでしょうか? 睡眠医療 12 : 599-602,2018. – reference: 24) Bajaj Y et al : Securing a nasopharyngeal airway. J Laryngol Otol 122 : 733-734, 2008. – reference: 9) Powell N et al : A reversible uvulopalatal flap for snoring and sleep apnea syndrome. Sleep 19 : 593-599, 1996. – reference: 6) Sasanabe R et al : Metabolic syndrome in Japanese patients with obstructive sleep apnea syndrome. Hypertens Res 29 : 315-322, 2006. – reference: 18) Hirata Y and Satoh M : Pilot study of the nasal airway stent for the treatment on obstructive sleep apnea. J Sleep Disord Ther 4 : 207, 2015. – reference: 20) Miyoshi T et al : Efficacy and tolerability of the nasal airway stent in the treatment of snoring. Clin Med Rev Case Rep 6 : 261, 2019. – reference: 15) Nahmias JS and Karetzky MS : Treatment of the obstructive sleep apnea syndrome using a nasopharyngeal tube. Chest 94 : 1142-1147, 1988. – reference: 1) Young T et al : The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328 : 1230-1235, 1993. – reference: 12) Walsh RE et al : Upper airway obstruction in obese patients with sleep disturbance and somnolence. Ann Intern Med 76 : 185-192, 1972. – reference: 26) Li S et al : The nasopharyngeal tube − A simple and effective tool to indicate the need for uvulopalatopharyngoplasty −. Laryngoscope 124 : 1023-1028, 2014. – reference: 5) Aronsohn RS et al : Impact of untreated obstructive sleep apnea on glucose control in type 2 diabetes. AM J Respir Crit Care Med 181 : 507-513, 2010. – reference: 14) Singh JR et al : The use of nasal trumpet in a traumatic brain injury patient with obstructive sleep apnea. PM&R 1 : 977-979, 2009. – reference: 25) Stoneham MD : The nasopharyngeal airway. − Assessment of position by fibreoptic laryngoscopy. Anaesthesia 48 : 575-580, 1993. – reference: 22) Camacho M et al : Inferior turbinate classification system, grades 1 to 4 − Development and validation study −. Laryngoscope 125 : 296-302, 2015. |
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Title | A study on the tolerability and effectiveness of a nasal airway stent in the management of obstructive sleep apnea in our clinic |
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