Title: First line of Moderate to Severe OSAHS Management-CPAP therapy vs Sleep Surgery

Abstract:

Objectives/Hypothesis: Our objective was to determine whether CPAP Therapy should still be considered as the First Line in the management of moderate to severe OSAHS and to compare it’s efficacy with advanced Sleep Surgery techniques.

Study Design: Prospective, nonrandomized trial.

Methods: There were 85 consecutive moderate to severe obstructive sleep apnea hypopnea syndrome (OSAHS) patients who had CPAP trial included in the study. Some of them underwent nose, palate, and/or tongue surgery following CPAP trial.

Results: There were 42 patients in the Surgery group and 43 patients in no-Surgery group. The mean preoperative body mass index (BMI) for the Surgery group was 26.6, whereas in the no-Surgery group it was 27.3. The mean preoperative systolic blood pressure (SBP) for the Surgery group was 138.0, whereas in the no-Surgery group it was 142.7. The mean preoperative diastolic blood pressure (DBP) for the Surgery group was 86.1, whereas in the no-Surgery group it was 88.3. The mean preoperative apnea-hypopnea index (AHI) for the Surgery group was 28.6, whereas in the no-Surgery group it was 32.7. The mean postoperative AHI for the Surgery group was 12.0, whereas in the no-Surgery group it was 14.2. The age-, gender-, BMI-adjusted percentage change in AHI for the Surgery group was −58.0, whereas in the no-Surgery group it was −56.6. The age-, gender-, and BMI-adjusted success rate for the Surgery group was 82.5%, whereas in the no-Surgery group it was 67.8%. The age-, gender-, and BMI-adjusted change in SBP for the Surgery group was −13.9, whereas in the no-Surgery group it was −8.9. The age-, gender-, and BMI-adjusted change in DBP in the Surgery group was −9.6, whereas in the no-Surgery group it was −6.4. The mean age- and gender-adjusted change in BMI for the Surgery group was −4.9, whereas in the no-Surgery group it was −3.3.

Conclusions: CPAP may not be considered as first line in the management of moderate to severe OSAHS.

Biography:

Sudipta Chandra has completed his MS (ENT) at the age of 30 years from Allahabad University, Fellowship of Sleep Medicine and Sleep Surgery from Asia Sleep Centre, Singapore and FRCS from Royal College of Physicians and Surgeons of Glasgow, UK. He is the Head of the Department of ENT and Head Neck Surgery at Belle Vue Clinic & PBAE Hospital, Kolkta, a premier Tertiary Care Corporate Hospital. He has published more than 25 papers in reputed journals and has been serving as an editorial board member of repute. He is the SAARC Regional Co-ordinator of World Sleep Society.