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Non-surgical treatment of the sleep related breathing disorders in adults Volume 90, issue 3-4, Septembre-Décembre 2019 - Numéro spécial international : Troubles Respiratoires Obstructifs du Sommeil et Orthodontie

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Introduction: The treatment of obstructive sleep apnoea/hypopnoea syndrome (OSAHS) must allow for the suppression of symptoms and also prevent its immediate and long-term consequences. Materials and Methods: The evaluation of the effectiveness of treatments is now based on a normal apnea/hypopnea index, a normal oxygen saturation and the disappearance of sleep fragmentation. Clinical and biological follow-up of co-morbidities must be ensured. Compliance with treatment, a major element of success, must be monitored. Results: Continuous Positive Airway
Pressure (CPAP) is still the most effective and widely used treatment. However, mandibular advancement orthosis is now recommended as a first-line treatment in moderate forms in the absence of severe cardiovascular comorbidities (CV) and remains a therapeutic alternative in the event of refusal or intolerance to CPAP. Nutritional management in cases of obesity and a physical activity program must be systematically offered. A reduction in nocturnal breathing disorders can also be achieved by using a device in the event of positional OSAHS, or by limiting fluid movements. The contribution of myofunctional therapy is currently being evaluated. Very recently, a study testing the efficiency of pharmacological treatment on the severity of OSAHS and the reactivity of geniogloss appears to be promising. Conclusion: The evaluation of these different treatments and their combination should make it possible to evolve towards a personalised management adapted to each patient.