Nico de vries

OLVG · Department of Ear, Nose and Throat (ENT)

Purpose Drug-induced sleep endoscopy (DISE) helps select patients with obstructive sleep apnea (OSA) for surgery by identifying upper airway collapse patterns. This study aimed to predict the probability of complete concentric collapse at the palatal level (CCCp) during DISE based on patient characteristics, specifically body mass index (BMI). Met...

Purpose Upper airway (UA) surgery is commonly employed in the treatment of patients with obstructive sleep apnea (OSA). The intricate pathophysiology of OSA, variability in sites and patterns of UA collapse, and the interaction between anatomical and non-anatomical factors in individual patients may contribute to possible surgical failures. This cl...

Study objectives: To determine the prevalence and risk factors of sleep bruxism (SB) in adults with primary snoring (PS). Methods: This study included 292 adults with PS (140 males, 152 females; mean age ± SD = 42.8 ±12.2 years; mean BMI ± SD = 26.7 ± 4.7 kg/m2) without previous treatment for snoring. SB was diagnosed based on the frequency of t...

Background Most of the respiratory events in adults with obstructive sleep apnea (OSA) occurs in supine position. It has been reported that the contraction of masseter muscles is dependent on the occurrence of arousals rather than on the occurrence of respiratory events. Objectives This study had two aims: (1) to compare the rhythmic masticatory m...

Purpose Treatment of head and neck cancer (HNC) may lead to obstructive sleep apnea (OSA), but conclusive results on the prevalence of OSA are lacking. The objective of this study is to investigate the prevalence of OSA in a cohort of patients treated for advanced T-stage HNC. Methods A cross-sectional study was conducted in two tertiary cancer ca...

Drug-induced sleep endoscopy (DISE) is a unique tool, which is used for evaluation of upper airway (UA) collapse in patients with obstructive sleep apnea (OSA). It provides additional information regarding the degree, level(s), and configuration of obstruction of the collapsible segment of the UA. The introduction of DISE has led to a better unders...

It has been suggested that, for patients with obstructive sleep apnea (OSA), identification of the obstruction site in the upper airway is essential in the treatment decision-making process. Due to the fact that all existing techniques for the identification of the obstruction site have drawbacks, there is a continuous search for more feasible meth...

Epiglottis collapse (EC) can be treated nonsurgically and/or surgically. The selection of treatment modality, however, can be challenging, involving some unease and controversy. In this chapter, we propose an assessment procedure for patients with EC, based on some published data and the authors’ own experience.

Treatment, either conservative or surgical, of an epiglottic collapse (EC) can be challenging. There is much uneasiness and controversy in what to do in case of the finding of an EC. EC, particularly a floppy epiglottis (FE), is a common phenomenon that appears almost exclusively in supine body position. Avoiding this posture may be the key to succ...

The global population is progressively affected by obesity. When conservative weight loss programs fail, bariatric surgery might be an option. Worldwide, more than 700,000 bariatric surgical procedures are performed on an annual basis. Obstructive sleep apnea (OSA) is the most prevalent sleep-disordered breathing problem and affects more obese indi...

Purpose To describe the temporal association between leg movements (LMs) and respiratory events in patients with obstructive sleep apnea (OSA), and to quantify the difference in scoring respiratory-related leg movement (RRLM) between the American Academy of Sleep Medicine (AASM) criterion and the criterion recommended by the World Association of Sl...

This study aims to assess (i) which acoustic characteristics of snoring sounds are associated with the annoying nature of snoring sounds; (ii) whether listeners’ heart rates correlate with their perceived annoyance; and (iii) whether perceived annoyance is different between listeners with different experiences with their bedpartners’ snoring sounds...

Study objectives This study aimed to investigate the effects of continuous positive airway pressure (CPAP) and mandibular advancement appliance (MAA) therapy on rhythmic masticatory muscle activity (RMMA), a biomarker of sleep bruxism (SB), and to compare the effects of CPAP with MAA in adults with obstructive sleep apnea (OSA). Methods This cohor...

Study objectives: To determine the prevalence and risk factors of sleep bruxism (SB); and to investigate the relationships between SB episodes, arousals, and respiratory events in adults with obstructive sleep apnea (OSA). Methods: This prospective study included 914 adults with OSA (305 females, 609 males; age = 53 years [interquartile range =...

Objective: To investigate the effect of frequently reported between-individual (viz., age, gender, body mass index [BMI], and apnea-hypopnea index [AHI]) and within-individual (viz., sleep stage and sleep position) snoring sound-related factors on snoring sound parameters in temporal, intensity, and frequency domains. Methods: This study include...

Background: It is important for dentists to know if the presence of snoring is associated with the presence of other dental sleep conditions (e.g., obstructive sleep apnea [OSA], sleep bruxism [SB], gastroesophageal reflux disease [GERD], xerostomia, and orofacial pain). If so, dentists could play a significant role in the early recognition and ma...

Purpose Obstructive sleep apnea (OSA) is prevalent in the bariatric population. OSA should be recognized in patients undergoing bariatric surgery preoperatively to prevent peri- and post-operative complications. Lipid metabolism-related biomarkers are associated with OSA. Triglyceride metabolism is, among others, regulated by angiopoietin-like prot...

This systematic review aimed to comparatively evaluate the efficacy and safety of maxillomandibular advancement (MMA) and upper airway stimulation (UAS) in obstructive sleep apnea (OSA) treatment. A MEDLINE and Embase database search of articles on MMA and/or UAS for OSA was conducted. Twenty-one MMA studies and nine UAS studies were included. All...

Background: Mandibular Advancement Devices (MAD's) are oral appliances commonly used in treatment of Obstructive Sleep Apnea (OSA). OSA severity and certain other factors, such as BMI and neck circumference, correlate with MAD therapy success. So far, the predictive value of dental parameters, such as dental profile, molar-classification, overjet,...

Nasal obstruction is believed to play a significant role in the pathophysiology and management of obstructive sleep apnea (OSA). However, controversy remains about the ability of isolated nasal surgery to improve OSA. The objective of this systematic review is to give an updated overview of the literature on whether isolated nasal surgery can impro...

Background: Evaluation and interpretation of the literature on obstructive sleep apnea is needed to consolidate and summarize key factors important for clinical management of the OSA adult patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International C...

Purpose Previous studies have shown a wide range of efficacy (29 to 71%) of a mandibular advancement device (MAD) in the treatment of obstructive sleep apnea (OSA). Currently, the ability to preselect suitable patients for MAD therapy based on individual characteristics related to upper airway collapsibility is limited. We investigated if the use o...

Background Weight-loss surgery is one of the recommended methods for treating obstructive sleep apnea (OSA) in obese patients. While weight reduction is critical to relieve symptoms of OSA, the biochemical factors involved in post-surgery improvement are still unknown. We aimed to explore the link between ANGPTL7 and OSA in patients with different...

The aim of this study was to compare the effects of maxillomandibular advancement (MMA) on respiratory function between obstructive sleep apnoea (OSA) patients with and without maxillomandibular deficiency, and to compare the changes in facial aesthetics after MMA between the two groups. MMA-treated patients who had both baseline and follow-up poly...

Objective Unilateral hypoglossal nerve stimulation (uniHNS) is an effective treatment for obstructive sleep apnea. Bilateral hypoglossal nerve stimulation (biHNS) is a novel therapeutic option and a different approach to hypoglossal nerve stimulation. The aim of this study was to analyze the clinical outcome of the first 10 biHNS cases vs the first...

Background: By being aware of the associated factors of primary snoring (PS) and obstructive sleep apnea (OSA) in sleep bruxism (SB) patients, dentists may contribute to the screening and early recognition of SB patients with PS or OSA. Objective: To identify the associated factors of PS and OSA from questionnaire-based data in SB patients. Met...

The aim of this study was to evaluate the clinical efficacy of maxillomandibular advancement (MMA) for obstructive sleep apnea (OSA) patients with a percentage of central and mixed apnea index in the total apnea−hypopnea index (CMAI%) ≧25%. Patients treated with MMA for OSA were retrospectively evaluated for baseline and postoperative patient data...

PurposeUpper airway stimulation (UAS) is an innovative treatment for patients with obstructive sleep apnea (OSA). UAS titrations are performed 3 months after activation of the device to optimize its effectiveness. In general, these titrations are performed during an in-laboratory overnight polysomnography (PSG). However, overnight titrations are ex...

Background Preoperative assessment of obstructive sleep apnea (OSA) in patients scheduled for bariatric surgery can be performed by in-laboratory polysomnography (PSG) or by portable polygraphy (PP) at home. We aimed to evaluate the association between PSG/PP, OSA diagnosis, and implementation of continuous positive airway pressure (CPAP) therapy....

Study objectives: Numerous types of mandibular advancement devices (MADs) are available to treat patients with obstructive sleep apnea (OSA), varying from non-custom to custom devices. Only a limited number of studies have been performed to determine whether a non-custom MAD could be used to predict treatment success of a custom MAD. In this study...

Study objectives: The primary aim was to predict upper airway collapse sites found in drug-induced sleep endoscopy (DISE) from demographic, anthropometric, clinical examination, sleep study, and snoring sound parameters in obstructive sleep apnea (OSA) patients. The secondary aim was to identify the above-mentioned parameters that are associated w...

Study objectives: Data on adherence and outcome of Upper Airway Stimulation (UAS) for patients with Obstructive Sleep Apnea (OSA) is collected in an International Registry (ADHERE). Previous publications report significant improvement in self-reported and objective OSA outcomes, durable effectiveness, and high adherence. Debate remains whether the...

Background and aims Severe obstructive sleep apnea (OSA) is associated with an increased risk of cardiovascular disease. Experimental evidence suggests that this risk may be mediated by chronic sympathetic hyperactivation and systemic inflammation, but the precise mechanisms remain to be unraveled. Our aim was to evaluate whether severe OSA patient...

Study objectives: (1) to investigate if DISE findings are predictive of surgical response for patients undergoing MMA for OSA; and (2) to investigate the predictive value of jaw thrust maneuver during DISE in terms of surgical response to MMA. Methods: A retrospective cohort study was conducted on patients with OSA who underwent a baseline polys...

Background Various case reports have described sudden sensorineural hearing loss (SSNHL) in patients with the 2019 novel coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Our aim was to determine the incidence of COVID-19 in patients with SSNHL. Methods All consecutive patients with audiomet...

PurposeSleep apnea is a multifactorial illness which can be differentiated in various physiological phenotypes as a result of both anatomical and non-anatomical contributors (e.g., low respiratory arousal threshold, high loop gain). In addition, the frequency and duration of apneas, in the majority of patients with OSA, are influenced by sleeping p...

Objective Systematic reviews on sleep bruxism (SB) as a comorbid condition of other sleep-related disorders are lacking. Such reviews would contribute to the insight of sleep clinicians into the occurrence of SB in patients with other sleep-related disorders, and into the underlying mechanisms of such comorbid associations. This systematic review a...

Purpose Depending on the severity of pre-treatment obstructive sleep apnea (OSA) and the criteria used to define treatment success, the efficacy of mandibular advancement devices (MADs) ranges from 30 to 69%. Identifying suitable candidates is the key to increasing the efficacy of a MAD. Positive predictors include a low body mass index, a low apne...

PurposeAs drug-induced sleep endoscopy (DISE) can provide additional diagnostic information on collapse patterns of the upper-airway, it is widely used in patients with obstructive sleep apnea (OSA). Although more controversial, DISE may also predict the success of treatment with a mandibular advancement device (MAD) and/or positional therapy (PT)....

Obstructive Sleep Apnea (OSA) is often treated with Mandibular Advancement Devices (MADs). It is unclear whether particular design features are superior to others in terms of OSA alleviation. In order to facilitate clinical decision-making, this systematic review summarizes the objective and subjective outcomes of different available MAD designs. S...

Background Identification of the obstruction site in the upper airway may help in treatment selection for patients with sleep-disordered breathing. Because of limitations of existing techniques, there is a continuous search for more feasible methods. Snoring sound parameters were hypothesized to be potential predictors of the obstruction site. Ther...

Objective The purpose of this study is to examine differences in therapy usage and outcomes of therapy between responder (R) and nonresponder (NR) groups in an international, multicenter prospective registry of patients undergoing hypoglossal nerve stimulation for obstructive sleep apnea (OSA). Study Design Database analysis (level III). Setting...

Purpose: Upper airway stimulation (UAS) is an innovative treatment for patients with obstructive sleep apnea (OSA). UAS titrations are performed 3 months after activation of the device to optimize its effectiveness. In general, these titrations are performed during an in-laboratory overnight polysomnography (PSG). However, overnight titrations are...

Objectives/Hypothesis To provide the ADHERE registry Upper Airway Stimulation (UAS) outcomes update, including analyses grouped by body mass index (BMI) and therapy discomfort. Study Design Prospective observational study. Methods ADHERE captures UAS outcomes including apnea-hypopnea index (AHI), Epworth sleepiness scale (ESS), therapy usage, pat...

Purpose: Almost two-thirds of the population undergoing bariatric surgery (BS) suffers from obstructive sleep apnea (OSA). Continuous positive airway pressure (CPAP) is the standard treatment for moderate to severe OSA and is recommended in patients undergoing BS perioperatively. A severe and dreaded complication after BS is anastomotic leakage. T...

Multilevel surgery (MLS) and maxillomandibular advancement surgery (MMA) are two established options in surgical management of obstructive sleep apnea (OSA), which target different levels of airway obstruction. The objective of this review was to comparatively evaluate the clinical efficacy and safety of MMA and MLS in the treatment of OSA. MEDLINE...

Drug-induced sleep endoscopy (DISE) is an upper airway evaluation technique in which fiberoptic examination is performed under conditions of unconscious sedation. Unique information obtained from this three-dimensional examination of the airway potentially provides additive benefits to other evaluation methods to guide treatment selection. This cha...

Dental sleep medicine traditionally focuses on sleep-related breathing disorders, such as snoring and obstructive sleep apnea. However, everyday practice shows that also other sleep disorders touch on dentistry, including sleep-related orofacial pain, xerostomia, hypersalivation, gastroesophageal reflux disease and bruxism. A new definition, which...

The definitive resource on the innovative use of DISE for obstructive sleep apnea Obstructive sleep apnea is the most prevalent sleep-related breathing disorder, impacting an estimated 1.36 billion people worldwide. In the past, OSA was almost exclusively treated with Continuous Positive Airway Pressure (CPAP), however, dynamic assessment of upper...

PurposeIn patients with positional obstructive sleep apnea (POSA), oral appliance therapy (OAT) is among the first-line treatments. The aim of this study was to evaluate the effects of a new standardized stepwise titration protocol for OAT in a group of patients with POSA.Methods This was an observational intervention trial. Patients who were previ...

Objectives This paper aimed to: retrospectively analyse single-centre results in terms of surgical success, respiratory outcomes and adverse events after short-term follow up in obstructive sleep apnoea patients treated with upper airway stimulation; and evaluate the correlation between pre-operative drug-induced sleep endoscopy findings and surgic...

Background Acromegaly is an uncommon syndrome caused by growth hormone-producing pituitary adenoma or pituitary gland hypertrophy. Acromegaly is known to be characterized by progressive somatic disfigurement and a wide range of systematic manifestations. This case study describes a rare case of severe obstructive sleep apnea (OSA) caused by acromeg...

Purpose To evaluate the influence of position-dependency on surgical success of upper airway (UA) surgery in obstructive sleep apnea (OSA) patients. Methods Systematic review. Results Two prospective cohort studies and seven retrospective cohort studies were included in this review. Despite the importance of the subject, it remains unclear whethe...

Introduction Excessive daytime sleepiness (EDS) in patients with obstructive sleep apnea (OSA) is associated with an increased risk of driving accidents. Solriamfetol, a dopamine/norepinephrine reuptake inhibitor, is approved in the US (Sunosi®) for EDS associated with OSA (37.5-150 mg/day). This study evaluated solriamfetol’s effects on on-road dr...

Purpose To analyze the presence of a floppy epiglottis (FE) during drug-induced sleep endoscopy in non-apneic snoring patients, non-positional obstructive sleep apnea (OSA) patients (NPP), and position-dependent OSA patients (PP) and to evaluate the impact of maneuvers and body position during drug-induced sleep endoscopy, including jaw thrust and...

Study objectives: 1) to analyse agreement in degree of obstruction and configuration of the upper airway (UA) between jaw thrust and an oral device in situ during drug-induced sleep endoscopy (DISE) 2) to evaluate clinical decision making using jaw thrust or a boil-and-bite MAD, the MyTAP. Methods: single-centre prospective cohort study in obstr...

Study objectives: (1) To evaluate surgical success in patients with obstructive sleep apnea undergoing maxillomandibular advancement (MMA) stratifying for the reduction of both the total apnea-hypopnea index (AHI) and the AHI in the supine and nonsupine position; (2) to evaluate the influence of position dependency on surgical outcome; and (3) to...

Purpose To evaluate the effect of a sleep position trainer (SPT) in patients with positional central sleep apnea (PCSA). Methods A multicentre cohort study was conducted. Patients with symptomatic PCSA were included. Effectiveness, compliance and quality of life were assessed at 1- and 6-month follow-up. Results Sixteen patients were included. Me...

Slaapgebonden ademhalingsstoornissen zijn afwijkingen van het ademhalingspatroon die zich alleen tijdens slaap voordoen, in tegenstelling tot bijvoorbeeld astma, dat zich overdag en tijdens slaap manifesteert. Slaapgebonden ademhalingsstoornissen worden veroorzaakt door een gedeeltelijke of volledige collaps van de bovenste luchtweg (BLW) tijdens d...

In dit hoofdstuk worden de aandoeningen van de neusbijholten besproken. Het gaat hierbij om rinosinusitis, retentiecysten en mucokèles, ontwikkelingsstoornissen, benigne en maligne tumoren, auto-immuun tumorachtige processen en traumata en fracturen.

Importance To date, no consensus exists regarding optimal perioperative care of patients with obstructive sleep apnea (OSA) undergoing upper airway (UA) surgery. These patients are at risk related to anesthesia and postoperative analgesia, among other risks associated with difficult airway control, and may require intensified perioperative manageme...

Background The severity of position-dependent obstructive sleep apnea (POSA) depends on the nonsupine and supine apnea–hypopnea index (AHI) as well as the time spent in supine position. The latter in particular is susceptible to variation. Several small-scale studies suggest that wearing polysomnography (PSG) apparatus leads to an increase in supin...

Hypoglossal nerve stimulation for obstructive sleep apnoea; technique, indication and future prospects Continuous positive airway pressure (CPAP) is the treatment of first choice in patients with moderate to severe obstructive sleep apnoea (OSA); however, 1 in 3 patients does not tolerate CPAP. Upper airway stimulation (UAS) is an alternative for C...

Objective To compare the effect of lateral head rotation to lateral head and trunk rotation on upper airway patency during drug‐induced sleep endoscopy (DISE) in nonpositional obstructive sleep apnea (OSA) patients (NPP) and positional OSA patients (PP). Methods Prospective cohort study. Results In total 92 patients were included. Seventy‐five pa...

Purpose: To evaluate the effect of different passive maneuvers on upper airway patency during drug-induced sleep endoscopy (DISE) compared to recent literature on treatment outcomes of positional therapy (PT), oral appliance therapy (OAT), and combined treatment in obstructive sleep apnea (OSA) patients. Methods: A retrospective, single-center c...

Purpose: To compare patient characteristics, upper airway (UA) collapse patterns and treatment outcome in obstructive sleep apnea (OSA) patients, including non-positional OSA patients (NPP) and positional OSA patients (PP), and non-OSA. Methods: Cohort-study of patients screened for OSA in 2012. Polysomnography was performed and UA was evaluated us...

Purpose To evaluate the effect of different passive maneuvers (lateral head rotation and jaw thrust) during drug-induced sleep endoscopy (DISE) on distribution of collapse patterns at the level of velum, oropharynx, tongue base, and epiglottis (VOTE). Methods Retrospective, single-center cohort study. Patients diagnosed with OSA who underwent DISE...

Background: The first edition of the European position paper (EPP) on drug-induced sleep endoscopy (DISE) was published in 2014 with the aim to standardise the procedure, to provide an in-depth insight into the main aspects of this technique and to have a basis for future research. Since 2014, new studies have been published concerning new sedativ...