K. Welch, G. Foster, C. Ritter at al.; 2002 |
Series of cases: 4 |
9 |
Behavioral treatment with a calorie-deficit diet of 1000–1500 kcal |
41–48 weeks |
MRI (T1) |
BMI: −6.1 ± 4.5 kg/m2, Weight: −17.1 ± 8.62 kg |
Non -apneic (RDI < 1 before and after) |
Airway volume (mm3) (retropalatal and retroglossal); Structural changes (Retropalatal: lateral walls); parapharyngeal fat deposits; Minimum retropalatal area (mm2); AP, pharyngeal lateral wall 26.8; Minimum retroglossal distance: latero-lateral, AP, lateral pharyngeal wall. |
L. Busetto, G. Enzi, Inelmen, I. E., et al.; 2005 |
Case-control: 3B |
17 |
Intragastric balloon |
25 weeks (6 months) |
Acoustic pharyngometry |
BMI: −7.2± 9.9kg/m2;
Weight: −24.1 ± 14.5 kg
|
59.3 ± 18.1–14.0± 12.4 (p<0.01) |
Orthostatic position: cross-sectional area of the pharynx at the level of the oropharyngeal transition, cross-sectional area of the pharynx. Supine position: cross-sectional area of the pharynx at the level of the oropharyngeal transition |
Sutherland, K.; Lee, R.; Phillips, C, et al.; 2011 |
Series of cases: 4 |
54 |
sibutramine 10 or 15 mg daily +2500 kJ daily deficit diet with exercise advice |
25 weeks |
CT |
Weight: −7.8±4.2kg |
41.0 (27.2–56.3) to 26.1 (14.9–38.0) |
Retropalatal volume; minimum velopharyngeal cross-sectional area, mean, latero-lateral diameter. Facial fat volume: mid-facial, lower facial, fat deposit. Hyoid to Posterior Nasal Spine (VA height) and Hyoid to C3. |
Santos, M.; Laureano Filho, J.; Campello, R, et al.; 2011 |
Series of cases: 4 |
17 |
Roux-en-Y Gastric Bypass |
17 weeks |
Cephalometry |
BMI: −11.7± 5.04 kg/m2;
Weight: −31.5± 14.9kg
|
Not assessed |
Facial type I: 9 vs. 10, II: 2 vs. 3, III 6 vs. 4. Angle between the nasion-sella and sella-C point lines (p < 0.001), Distance from the sella to the nasion (p = 0.038), Velopharyngeal space (p = 0.001), Distance from the hyoid bone to the chin (p = 0.042). predominance of Mallampati categories III and IV in the preoperative period and predominance of categories I and II in the postoperative period (p = 0.016). amygdala NS |
Pahkala, R.; Seppä, J.; Ikonen, A, et al.; 2014 |
RCT: 1B |
36 |
Very low calorie diet+dietary advice + exercise recommendation vs. dietary advice + exercise recommendation |
1 year |
CT |
BMI intervention: −3.6± 3.0kg/m2 (p< 0.001); control −1.6± 3.0kg/m2 (p = 0.038) |
Intervention: − 10.0± 2.9 to −6.0±4.8 (p< 0.001); control −9.7 ±3.6 to −8.5 ±7.6 (p = 0.061) |
Fat deposit area (p = 0.003); control NS. |
Naughton, M.; Monteith, B.; Manton, D. et al.; 2015 |
RCT: 1B |
54 |
Adjustable gastric banding surgery vs. diet |
24 months |
Cephalometry |
BMI: −6.7± 6,.5 kg/m2 (p< 0.001);
Weight: −16.8± 23.8 kg (p< 0.001)
|
Intervention: 60.1 ±27.0– 40.4 ±27.0 ev/h (p< 0.001);
Control: 9.7–8.5 (p = 0.061)
|
Pre-measures as predictors for % AHI change: Mandibular body (menton – gonion) was associated with % AHI change (r = 0.45; and in % weight change (r = 0.37; without adjustment for variables. Mandibular length also correlated with change in % AHI, Gn-Go (r = 0.28). |
Sutherland, K.; Phillips, C; Yee, B. et al.; 2016 |
Series of cases: 4 |
52 |
Sibutramine 10 or 15 mg daily +2500 kJ daily deficit diet with exercise advice |
24 weeks |
CT |
BMI: −2.5 ±2.9 (p< 0.001);
Weight: −7.8± 12.8 (p< 0.001), variation −7.4%
|
42.9 ± 21.3– 26.8± 15.9 (p<0,.001), variation −34.1% |
Small, medium and large maxillomandibular volume (adjusted for height): small maxillomandibular volume (159.7–212.7cm3) there was a strong correlation between weight loss and OSA improvement (rho = 0.65). |
Al-Jumaily, A.; Ashaat, S.; Martin, B, et al.; 2018 |
Series of cases: 4 |
10 |
Roux-en-Y Gastric Bypass |
6M/12 M |
CT |
BMI: 6 months −48,.5±6.5 to 33.7±4.0 (p<0.05); 12 months – 30.3 ±3.6 |
AHI: 6 months 38.1 ±29.4 to 15.7± 15 (p<0.05); 12 months 5.6± 10.2 (n = 6, p<0.05) |
Upper airway volume: 17,032+/−9691 to 17,749+/−6258 (6 months) and 18,262.3±4256.6mm3 (12 months). |
Wang, S.; Keenan, B.; Wiemken, A, et al.; 2020 |
Series of cases: 4 |
47 |
Lifestyle change for weight loss: calorie restriction + increased physical activity + behavioral modifications (n = 49). Bariatric surgery (n = 18; sleeve gastrectomy (n = 8), Roux-en-Y gastric bypass; (n = 9), or gastric banding (n = 1) |
6M |
MRI (T1) |
BMI: −6.4±5.8kg/ m2 (p< 0.001);
Weight −18.6 ±16.9kg
|
AHI: 41.4±27.6– 18.6 ± 20.0 ev/h (p = 0.004) |
Obtained from the supplement (n = 45). Variations of absolute measures. Retropalatal AP distance, minimum lateral distance. Soft tissue volumes: Total soft tissue, genioglossus, tongue fat, fat deposits, pterygoid, retropalatal lateral walls and total lateral walls. |
Sutherland, K.; Chapman, J.; Cayanan, E, et al.; 2021 |
Secondary review of 3 databases: 3B |
91 |
Study 1: hypocaloric diet + lifestyle for 6 months (n = 58, 63.7% N). Study 2: maintenance diet for up to 12 months (n = 17, 18.7% N). Study 3 (n = 16, 17.6% N) bariatric surgery |
6–12M |
Craniofacial photography |
BMI: −3.9 ±5.1 (p< 0.001);
Weight: −11.6± 15.4
|
AHI: 36.2 ±21.3– 27.0 ±20.4 (p< 0.001) |
Obtained from the supplement. Mean maxillomandibular angle (◦): 5.3 ±2.4. Mean mandibular length (cm): 9.1 ± 1.2. 1st increase in maxillary-mandibular relationship angle predicts a decrease in AHI of 4.1% or 1.7ev/h |