Sleep apnea and nasal stents

The cause of sleep apnea is typically said to be a falling back of the tongue. However, according to scientific literature, this only applies to a small proportion of patients. In most patients, the soft palate and upper pharyngeal walls contract. The causes of these closures are physical and can be anatomical or due to swelling in the nose, as well as due to impaired nasal function.

The Alaxo products can therefore be used for sleep apnea in three ways:.

- the AlaxoLito Plus or Xtreme Nasal Stents to improve nasal breathing (see "restricted nasal breathing")

- the AlaxoStent C for splinting the upper pharynx (at the site of collapse)

- for CPAP users the AlaxoLito Plus or Xtreme nasal stents to counteract the frequent swelling of the nasal turbinates under artificial ventilation and to keep the CPAP pressure lower.

The AlaxoStent C is inserted through the nose into the upper pharynx for sleeping and removed after sleeping. It splints the upper pharynx but not the nasal passage.

The two major AlaxoStent components: stent and introduction tube

If necessary, a combination of AlaxoStent C with AlaxoLito Plus Nasal Stent may be useful in order to use mechanical splinting in the pharynx as well as in the nose. A combination of the Alaxo stent products with an oral appliance may also be useful to extend mechanical splinting to the tongue base.

Scheme for positioning of the AlaxoStent

The application of the AlaxoStent is demonstrated in the following video

Clinically tested

The effectiveness of the AlaxoStent has been demonstrated in several clinical trials (1-3). In a sleep laboratory study with the first generation AlaxoStent (1), it was found to eliminate dangerous apneas (full airway obstruction in the throat) as efficiently as CPAP therapy in patients with mild and moderate obstructive sleep apnea without tongue base collapse. Even in a very severe case of obstructive sleep apnea (AHI >70/h), a very good result (AHI approximately 10/h) was observed (2).

Using the first (2) and second (3) generation AlaxoStent, videoendoscopic studies were also performed in propofol-induced artificial sleep in patients with mild, moderate, and very severe obstructive sleep apnea. It was visually demonstrated that the upper pharynx is kept open very reliably (1+3). This was subsequently further confirmed outside of clinical studies in numerous individual case observations.

(1) Traxdorf et al.; A novel nasopharyngeal stent for the treamtent of obstructive sleep apnea: a case series of nasopharyngeal stenting versus continuous positive airway pressure; European Archives of Oto-Rhino-Laryngology 273, 1307-1312 (2016). DOI 10.1007/s00405-015-3815-2

(2) Juhász; Nitinol pharyngealer Stent zur Beseitigung der Atemwegsobstruktion bei Schlafapnoe; DGSM-Tagung 2011

(3) Powell et al.; Pilot study assessing the efficacy of a novel treatment for sleep related breathing disorders in patients undergoing sleep nasendoscopy; Clinical Otolaryngology 39(3), 190-194 (2014).
DOI: 10.1111/coa.12253

Further scientific publications:

Klaus Düring; Wiederherstellung der gesunden natürlichen Nasenatmung als Therapie der Schlafatmung, DGSM-Konferenz 2019, Hamburg, Deutschland
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Klaus Düring; Mechanical splinting of the nasal and velopharyngeal airway for patency of the upper airway in OSA; Abstracts of the 9th International Sleep Surgical Society Meeting 2018, Munich, Germany; Sleep Breath (2018) 22: 865.
doi.org/10.1007/s11325-018-1692-9
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