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A novel intermittent negative air pressure device ameliorates obstructive sleep apnea syndrome in adults

  • Tzu-Chun Hung
  • Tien-Jen Liu
  • Wen-Yeh Hsieh
  • Bo-Nien Chen
  • Wen-Ko Su
  • Kuang-Hui SunEmail author
  • Christian Guilleminault
Sleep Breathing Physiology and Disorders • Original Article
  • 26 Downloads

Abstract

Purpose

Patients with obstructive sleep apnea syndrome (OSAS) have difficulties in compliance with continuous positive airway pressure (CPAP) and the treatment outcome is heterogeneous. We proposed a proof-of-concept study of a novel intermittent negative air pressure (iNAP®) device for physicians to apply on patients who have failed or refused to use CPAP.

Methods

The iNAP® device retains the tongue and the soft palate in a forward position to decrease airway obstruction. A full nightly usage with the device was evaluated with polysomnography. Subgrouping by baseline apnea–hypopnea index (AHI) and body mass index (BMI) with different treatment response criteria was applied to characterize the responder group of this novel device.

Results

Thirty-five patients were enrolled: age 41.9 ± 12.2 years (mean ± standard deviation), BMI 26.6 ± 4.3 kg/m2, AHI 41.4 ± 24.3 events/h, and oxygen desaturation index (ODI) 40.9 ± 24.4 events/h at baseline. AHI and ODI were significantly decreased (p < 0.001) by the device. Patients with moderate OSAS, with baseline AHI between 15 to 30 events/h, achieved 64% response rate; and non-obese patients, with BMI below 25 kg/m2, achieved 57% response rate, with response rate defined as 50% reduction in AHI from baseline and treated AHI lower than 20. There were minimal side effects reported.

Conclusions

In a proof-of-concept study, the device attained response to treatment as defined, in more than half of the moderate and non-obese OSAS patients, with minimal side effects.

Keywords

Obstructive sleep apnea syndrome Sleep-disordered breathing Apnea–hypopnea index Intermittent negative air pressure Intraoral device Oral pressure therapy 

Notes

Author contributions

Conception and design of this manuscript: T.C. Hung, C. Guilleminault

Acquisition of data: T.J. Liu, W. Y. Hsieh, B.N. Chen, W.K. Su

Analysis and/or interpretation of data: T.C. Hung

Drafting and revision of the manuscript: T.C. Hung

Revising and reviewing the manuscript for final releasing: K.H. Sun, C. Guilleminault

Funding

This study was sponsored by Somnics, Inc.

Compliance with ethical standards

Ethical approval

The study was approved by the MacKay Memorial Hospital Institutional Review Board and registered to the National Department of Health. The study was performed in accordance with applicable local regulations, International Conference on Harmonization Guidelines as well as the 1964 Declaration of Helsinki and its later amendments. All subjects were properly informed and consented to participate in this study.

Conflict of interest

T.C. Hung is employed by Somnics, Inc., and is currently a PhD student at National Yang-Ming University. Besides T.C. Hung, the other authors declare that they have no conflict of interest.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Tzu-Chun Hung
    • 1
  • Tien-Jen Liu
    • 2
    • 3
  • Wen-Yeh Hsieh
    • 4
  • Bo-Nien Chen
    • 2
  • Wen-Ko Su
    • 5
  • Kuang-Hui Sun
    • 1
    • 6
    Email author
  • Christian Guilleminault
    • 7
  1. 1.Department of Biotechnology and Laboratory Science in MedicineNational Yang-Ming UniversityTaipeiTaiwan
  2. 2.Department of Otolaryngology Head & Neck SurgeryMacKay Memorial Hospital, Taipei BranchTaipeiTaiwan
  3. 3.School of Biomedical EngineeringTaipei Medical UniversityTaipeiTaiwan
  4. 4.Division of Chest MedicineMacKay Memorial Hospital, Hsinchu BranchHsinchuTaiwan
  5. 5.Department of RadiologyMacKay Memorial Hospital, Hsinchu BranchHsinchuTaiwan
  6. 6.Department of Education and ResearchTaipei City HospitalTaipeiTaiwan
  7. 7.Division of Sleep MedicineStanford UniversityRedwood CityUSA

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