The Tongue Muscle Training (ZMT®) in nCPAP Patients with Obstructive Sleep Apnea Syndrome (OSAS)

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Abstract

Obstructive Sleep Apnea Syndrome is treated not only with the help of nCPAP but by other means which help to support the sufficient level of pharyngeal airways. In course of our experiment we investigated changes in parameters of breath during night sleep in patients with high indices of obstructive Sleep Apnea Syndrome after the tongue muscle training. 40 patients with OSAS treated only with the help of nCPAP underwent a 5-week course of electrical stimulation of upper pharyngeal muscles. This type of treatment was supposed to result in dilatation of pharyngeal airways and cure of occlusion and obstruction. Parameters of breath during the night sleep before- and after the treatment were detected with the help of somno-poligraphic investigations and compared. Indices of apnea and hypopnea decreased in 26 of 40 patients, which is more than half of the probands. We recommended the patients with a diagnosed OSAS without a risk of recurrence to add tongue muscle training to nCPAP. In case the course of nCPAP therapy is launched it helped achieve sufficient improvement of parameters affecting breath during the night sleep and in many cases decrease respiratory pressure of nCPAP therapy or its complete cessation .

General Information

Keywords: Stimulation of muscles; Obstructive Sleep Apnea Syndrome (OSAS); Tongue Muscle Training (ZMT®)

Journal rubric: Medical Psychology

Article type: review article

For citation: Gessmann H. The Tongue Muscle Training (ZMT®) in nCPAP Patients with Obstructive Sleep Apnea Syndrome (OSAS) [Elektronnyi resurs]. Sovremennaia zarubezhnaia psikhologiia = Journal of Modern Foreign Psychology, 2013. Vol. 2, no. 2, pp. 63–86. (In Russ., аbstr. in Engl.)

References

  1. Appell H.-J. Über den Einsatz der Elektrostimulation zur Muskelkräftigung in Therapie und Rehabilitation // Physikalische Therapie. 1987. № 8. P. 474-480.
  2. Broniatowski M. The potential for neurostimulation in obstructive sleep apnea // ASAIO Journal. Vol. 40, Iss. 1. P. 13-16.
  3. Edmonds L.C. The effects of transcutaneous electrical stimulation during wakefulness and sleep in patients with obstructive sleep apnea / L.C. Edmonds, B.K. Daniels, A.W. Stanson, P.F. Sheedy, J.W. Shepard // The American review of respiratory disease. 1992. Vol. 146, Iss. 4. P. 1030-1036.
  4. Gessmann H.-W. Training der suprahyoidalen Muskulatur bei fünf Patienten mit obstruktiver Schlafapnoe. Duisburg : Verlag des PIB, 1998.
  5. Gessmann H.-W. Rekrutierung der suprahyoidalen Muskulatur durch externe Elektrostimulation zur Prävention und Behandlung des Schlafapnoe-Syndroms. Duisburg : Verlag des PIB, 2000.
  6. Guilleminault C. The effect of electrical stimulation on obstructive sleep apnea syndrome / C. Guilleminault, N. Powell, B. Boman, R. Stoohs. // Chest. 1995. Vol. 107, Iss. 1. P. 67-73.
  7. Hochban W. Das obstruktive Schlafapnoesyndrom. Berlin ; Wien Blackwell: 1995.
  8. Hudgel D. Mechanics of the respiratory system and breathing pattern during sleep in normal humans / D. Hudgel, R. Martin, B. Johnson, Hill, P. Journal Applied Physiology. 1984. № 56. P. 133-137.
  9. Knaak L. Die oberen Atemwege im Schlaf. In: Schulz (Hrsg.): Kompendium Schlafmedizin für Ausbildung, Klinik und Praxis, Kap. VI-3, Respiratorisches System. ecomed, Landsberg, 1997.
  10. Knaak L. Therapie von Atemstörungen – Neuromuskuläre Stimulation. In: Schulz (Hrsg.): Kompendium Schlafmedizin für Ausbildung, Klinik und Praxis, Kap. XIV-5, Respiratorisches System. ecomed, Landsberg, 1999.
  11. Korhonen P. Experiments with cluster analysis criteria based on the within groups scatter matrix // COMPSTAT / H. Caussinus (Ed.). Wien : Physica-Verlag, 1982. P. 266-272.
  12. Lavie P. Mortality in sleep apnea patients : a multivariate analysis of risk factors / P. Lavie, P. Herer, , J. Peled et al. // Sleep. 1995. Vol. 18, Iss. 3, P. 149-157.
  13. Miki H. Effects of the electrical stimulation of the genioglossus on upper airway resistance in anesthetized dogs / H. Miki, W. Hida, D. Shindoa, Y. Kikuchi, T. Chonan, O. Tagichi // The American review of respiratory disease. 1989. Vol. 140, Iss. 5. P. 1279-1284.
  14. Miki H. Effects of submental stimulation during sleep on upper airway patency in patients with obstructive sleep apnea / H. Miki, W. Hida, T. Chonan Y. Kikuchi, , T. Takishima // The American review of respiratory disease. 1989. Vol. 140, Iss. 5. P. 1285-1289.
  15. Podszus T. Electrical hypoglossus nerve stimulation in obstructive sleep apnea / T. Podszus, J. Peter, W. Hochban et al. // The American review of respiratory disease. Dis. 1995. Vol. 151, A538.
  16. Rechtschaffen A., Kales A. A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. Public Health Service, US Government Printing, 1968. P. 1-12.
  17. Remmers J. Pathogenesis of upper airway occlusion during sleep / J.E. Remmers, W.J, Degroot, E.K. Sauerland, A.M. Anch // Journal of Applied Physiology. 1978. Vol. 44, Iss.6. P. 931-938.
  18. Schwartz A.R. Electrical genioglossal stimulation increases airflow and attenuates obstructive apnea during sleep / A.R. Schwartz et al. // The American review of respiratory disease. 1993. Vol. 147, A251.
  19. Schwartz A. Effect of electrical stimulation of the hypoglossus nerve on airflow mechanics int the isolated upper airway / A. Schwartz, D. Thut, B. Russ, M. Seelagy, X. Yuan, R. Browner, S. Permutt, R. Wise, P. Smith // The American review of respiratory disease. 1993. Vol. 147, Iss. 5. P. 1144-1150.
  20. Shepard J.¸Thawley S. Localization of upper airway collapse during sleep in patients with obstructive sleep apnea // The American review of respiratory disease. 1990. Vol. 141, Iss. 5. P. 1350-1355.
  21. Smith P. Electrical stimulation of upper airway musculature / P. Smith, D. Eisele, T. Podszus, T. Penzel, L. Grote, J. Peter, A. Schwartz // Sleep. 1996. Vol. 19, Iss. 10. P. S284-S287.
  22. Stahl H. Eine Methode zur graphischen Darstellung multivarianter Daten. Berlin : Diss. TU-Berlin, 1981.
  23. Stahl H. Clusteranalyse großer Objektmengen mit problemorientierten Distanzmaßen. Thun ; Frankfurt/M. : Verlag Harri Deutsch, 1985.
  24. Wiltfang J. Erste Ergebnisse zum Training der suprahyoidalen Muskulatur bei Probanden und einem Patienten mit obstruktiver Schlafapnoe / J. Wiltfang, S. Klotz, W. Jordan, S. Cohrs, W. Engelke, A. Ludwig, G. Hajak // Somnologie. 1997. Vol. 1, Iss. 4, P. 160-164.
  25. Wiltfang J. First results on daytime submandibular electrostimulation of suprahyoidal muscles to prevent night-time hypopharyngeal collapse in obstructive sleep apnea syndrome / J. Wiltfang, S. Klotz, W. Jordan, S. Cohrs, W. Engelke, A. Ludwig, G. Hajak // International Journal of Oral and Maxillofacial Surgery. Vol. 28, Iss.1. P. 21-25.
  26. Yoshida K., Thumm J., Siebert G.K. Kau- und Zungenmuskelaktivität bei Schlafapnoikern und bei Schnarchern // Dtsch Zahnärztl. 1995. № 50. P. 387-389.

Information About the Authors

Hans-Werner Gessmann, Doctor of Clinical Psychology, Director of the Center of Excellence, Diagnostics and Therapy, University of California, Psychotherapy Institute Bergerhausen (Duisburg, Germany), Duisburg, Germany, e-mail: h.w.gessmann@gmail.com

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