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- Fehrm, Johan, et al.
(författare)
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Blood pressure after modified uvulopalatopharyngoplasty : results from the SKUP3 randomized controlled trial.
- 2017
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Ingår i: Sleep medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 34, s. 156-161
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveObstructive sleep apnea (OSA) is a risk factor for hypertension. The SKUP3 study showed that modified uvulopalatopharyngoplasty (UPPP) significantly improved nocturnal respiration, sleepiness, and quality of life. The aim of this study was to evaluate the impact of surgery on blood pressure in patients with OSA.MethodsWe used a single-center randomized controlled trial to compare modified UPPP with controls at baseline and after six months. The controls received delayed surgery with an additional six-month follow-up. All operated patients also had a follow-up after 24 months. Polysomnography was performed at each follow-up, with systolic and diastolic blood pressure (SBP, DBP) measured the morning after.ResultsA total of 65 patients were randomized to intervention (n = 32) or control (n = 33). At follow-up (n = 61/65, 94%), there were significant differences between the groups in both mean SBP (−9.4 mmHg [95% CI: −17.9, −0.83], p < 0.05) and mean DBP (−6.4 mmHg [95% CI: −12.8, −0.04], p < 0.05), in favor of UPPP. Blood pressure and respiratory parameters at follow-up correlated. The analyses of all operated patients showed a significant decrease in mean (SD) blood pressure after six months (n = 49/65, 75%; SBP: −4.5 [9.0], p = 0.001; DBP: −2.2 [6.6], p = 0.030) as well as after 24 months (n = 35/65, 54%; SBP: −8.9 [11.5], p < 0.0001; DBP: −4.2 [9.4], p = 0.012).ConclusionsBlood pressure was significantly decreased after surgery, indicating that modified UPPP decreases the blood pressure, in a selected group of patients with moderate to severe OSA. The long-term effect was also significant, but these results are uncertain due to a high proportion of missing values.
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| 2. |
- Sundman, Joar, et al.
(författare)
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Sleep Quality After Modified Uvulopalatopharyngoplasty : Results From the SKUP3 Randomized Controlled Trial
- 2018
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Ingår i: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 41:1
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Tidskriftsartikel (refereegranskat)abstract
- Study Objectives: To investigate whether uvulopalatopharyngoplasty (UPPP) improves sleep quality in patients with Obstructive Sleep Apnea (OSA) using the Functional Outcomes of Sleep Questionnaire (FOSQ) and the Karolinska Sleep Questionnaire (KSQ).Methods: Randomized controlled trial used to compare modified UPPP, with controls at baseline and after six months. The controls received delayed surgery and a six-month postoperative follow-up. All operated patients were offered a 24-month follow-up. At each follow-up, patients underwent polysomnography and vigilance testing and completed questionnaires. Nine scales were evaluated: five subscales and the total score in the FOSQ and three subscales in the KSQ.Results: Sixty-five patients, mean 42.3 years (SD 11.5), Friedman stage I and II, BMI <36 kg/m 2, moderate to severe OSA, were randomized to intervention (n = 32) or control (n = 33). In the FOSQ and in the KSQ, the mean rate of missing values was 6.2% (range 0-19%) and 20.5% (3-38%), respectively. In 8 of 9 scales, significant differences were observed between the groups in favor of UPPP. There were significant correlations between results from the questionnaires and objective measures from polysomnography and the vigilance test. At the six and 24-month postoperative follow-ups, 8 of 9 scales were significantly improved compared to baseline.Conclusions: In selected patients with OSA, subjective sleep quality was significantly improved six months after UPPP compared to controls, with stable improvements 24 months postoperatively. The correlations between subjective and objective outcomes, and the long-term stability suggest a beneficial effect from surgery, although a placebo effect cannot be excluded.
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