The Efficacy and Maintain Effect of OPR on OSA Patients After Palatal Surgery

PSG will include electroencephalography, electrooculography, electromyography, thoracic and abdominal respiratory inductance plethysmography, body position sensor-modified lead II electrocardiography, oronasal thermistor, nasal cannula pressure transducer, finger pulse oximetry. The detail descriptions of each measurement are in secondary outcome measure.

From the abouve measurements, OSA severity, defined using AHI, will be diagnosed by sleep medicine specialists in the ear, nose, and throat (ENT) department. AHI denotes the number of instances of apnea and hypopnea per hour during sleep. Apnea was defined as a >90% decrease in airflow and a >10-s cessation of airflow, and hypopnea was defined as a >30% decrease in airflow and >3% decrease in oxygen desaturation or microarousal. AHI of 5 to <15, 15 to <30, ≥30 denotes mild, moderate, and severe OSA, respectively.

Each participant will maintain their tongues in the resting position, without swallowing, during CT. Pharyngeal airway volume, minimal cross-sectional areas, minimal distance between the lateral pharyngeal wall on both sides, and minimal distance between the anterior and posterior pharyngeal wall on the tip of the epiglottis will be measured. The detail description of each measurement are in secondary outcome measure. Experienced radiologists will perform image reconstruction and data analysis.

Tongue muscle strength will be evaluated on the IOPI system (model 2.2; Northwest, Carnation, WA, USA). The participants will sit in a relaxed position, with their heads parallel to the horizontal plane and their feet on the ground. The evaluation probe will comprise a balloon and plastic catheter. The participants will squeeze the balloon for 3 s at maximum pressure. The maximum pressure of protrusion, lateralization, elevation, and depression will be considered the highest of three measurements, expressed in kilopascals.

We will use ESS to evaluate daytime sleepiness. We will use PSQI to assess sleep quality and patterns. SOS consists of eight items related to the frequency, duration, severity, and consequences associated with sleep-disordered breathing and specifically snoring. Because of the effect of sleep-disordered breathing on partners, a separate Spouse/Bed Partner Survey (SBPS), comprising three Likert-type items, will also be used.

Electroencephalogram (EEG) is a test that measures electrical activity in the brain using small, metal discs (electrodes) attached to the scalp. It will be used to determine the sleeping stages of the participants.

Electrooculography (EOG) is a technique for measuring the corneo-retinal standing potential that exists between the front and the back of the human eye. It will be used to know the participants is in repeat eye movement stage or non-repeat eye movement stage.

Electromyography (EMG) is a technique for evaluating and recording the electrical activity produced by skeletal muscles. EMG will be used to evaluate limb movement during sleep. Surface EMG will be used in PSG.

Thoracic and abdominal respiratory inductance plethysmography is a method of monitoring pulmonary ventilation by measuring the movement of the chest and abdominal wall. Phase relation between thorax and abdomen classifies apnea/hypopnea events into central, mixed, and obstructive types.

It will be used to monitor the particiapants is in supine position or sidelying position.

It will be used to monitor airflow from nose and evaluate epoch of hypopnea. Airflow is in L/sec.

It will be used to monitor temperature from mouth and evaluate epoch of apnea. Temperature is in degree of celsius.

It will be used to evaluate SpO2. SpO2 is in %.

Pharyngeal airway volume from the hard palate to the epiglottis will be measured. Volume in cm cubed.

The minimal cross-sectional areas on the tip of the epiglottis will be measured. Areas in cm.

Minimal distance between the lateral pharyngeal wall on both sides, and minimal distance between the anterior and posterior pharyngeal wall on the tip of the epiglottis will be measured. Distance in cm.

ESS consists of eight situations measured on a scale of 0-3, representing no, occasional, common, and frequent sleepiness, respectively. The scores for the eight situations are totaled. Total scores of 0 to 10 points represent normal results, whereas total scores of 11-24 points indicate high levels of daytime sleepiness.

It consists of nine items covering seven domains: subjective sleep quality, sleep latency, sleep duration, sleep disturbances, habitual sleep efficiency, sleep medication use, and daytime dysfunction. The participants' responses were based on the coditions in the month prior. The total scores range from 0 to 21 points, and a total score of >5 points indicates poor sleep.

SOS consists of eight items related to the frequency, duration, severity, and consequences associated with sleep-disordered breathing and specifically snoring. Because of the effect of sleep-disordered breathing on partners, a separate Spouse/Bed Partner Survey (SBPS), comprising three Likert-type items, was also used. The scores on the SOS and SBPS were normalized to the range of 0 (worst) to 100 points (best).