Mouth Closure May Worsen Airflow in Patients with Severe Obstructive Sleep Apnea, unravels study

Researchers found that clenching the mouth at night may help to exacerbate airflow in patients suffering from obstructive sleep apnea (OSA), especially those who are more dependent on mouth breathing. A new study contradicts the recent hype of “mouth taping” as a preventive measure against mouth breathing, concluding that this is the wrong approach to take for certain OSA patients.

Obstructive sleep apnea (OSA) is characterized by repeated episodes of airway obstruction during sleep, which causes disrupted breathing and poor oxygen levels. Most commonly, it is typical in patients with OSA to breathe through the mouth, but more recently, there’s been the hashtag on TikTok of “mouth taping” as a treatment method for OSA-forced nasal breathing. According to a new study by Daniel Vena, PhD from Brigham & Women’s Hospital and Harvard Medical School, this practice raises issues about safety and efficacy.

For the research, the mouths of 54 patients were manually closed during the period of drug-induced sleep to determine their effects on airflow. The outcomes were that mouth closure improved airflow in some patients but worsened it in others, particularly those who relied mainly on mouth breathing.

The study published in JAMA Otolaryngology-Head & Neck Surgery aimed to evaluate the effect of oral closure during sleep on airflow. Altogether 54 adult OSA patients were studied, with a median age of 55 years, BMI of 28.9, and an apnea-hypopnea index of 26.9 events/hour. Researchers induced sleep with propofol and manually closed the patients’ mouths to see whether or not they would alter the airflow.

  • In the 32 patients who experienced mild mouth breathing (oral airflow before maneuver was 0.05 to 2.2 L/min), manually occluding the mouth resulted in a 53.1 percentage-point increase in airflow, equivalent to 2.0 L/min.

  • In the 12 patients who were major mouth breathers (>2.2 L/min oral ventilation during normal sleep), mouth closure reduced ventilation by 40 percentage points or 1.86 L/min (95% CI -3.1 to -0.6).

  • Patients suffering the worst obstruction of the soft palate and destined for mouth breathing demonstrated the biggest drops in flows, because their mouths were closed.

Propofol was administered to sleep-induced patients for routine clinical endoscopies and airflow measurements. Researchers operated to alternately close the mouth and then release it in order to see the effect on breathing. In each patient, at least 15 breath cycles were recorded, alternating between mouth closure and relaxed mouth positioning.

There were a number of limitations to the study. It was an acute outcome trial measuring single breath effects rather than long-term outcomes, so these results may not reflect the longer-term impact of forced mouth closure during sleep. Moreover, the contribution of nasal obstruction to open-mouth breathing was not measured and could be a critical factor in explaining these findings.

Researchers advise doctors to take proper caution in recommending such treatments like using mouth tapes and monitor patients closely so the therapy doesn’t worsen their disease condition. Long-term effects of such therapies on OSA patients should be explored as well.

Reference:

Yang, H., Huyett, P., Wang, T.-Y., Sumner, J., Azarbarzin, A., Labarca, G. P. T., Messineo, L., Gell, L. K., Aishah, A., Hu, W.-H., White, D. P., Sands, S. A., Wellman, A., & Vena, D. (2024). Mouth closure and airflow in patients with obstructive sleep apnea: A nonrandomized clinical trial. JAMA Otolaryngology– Head & Neck Surgery. https://doi.org/10.1001/jamaoto.2024.3319

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NEET PG 2024 Counselling Schedule Expected in 2 to 3 Days, informs Doctors’ Association

The National Eligibility-and-Entrance Test Postgraduate (NEET-PG) exam aspirants might soon get clarity regarding their admission process as the authorities might release the tentative schedule for the exam in the next two to three days.

Dr. Lakshya Mittal, the president of the United Doctors Front Association (UDFA), mentioned in an X (formerly Twitter) post that the tentative schedule for the NEET-PG 2024 exam is expected to be updated within the next 2-3 days.

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Manipal Hospitals Buys Hospital Property Worth Rs 415 Crore in Mumbai’s Andheri

Mumbai: Manipal Hospitals, backed by Singapore’s global investment company Temasek Holdings, has purchased a hospital property worth Rs 415 crore in Mumbai’s Andheri.

As per the documents, accessed by Propstack, the Deed of Transfer was registered between the seller Khubchandani Properties and Investment Private Limited and Manipal Health Enterprises Private Limited on October 7, HT has reported. 

The new hospital property, purchased by Manipal Hospitals, is spread across an area of 10,590 sq m. The hospital has been developed on a land parcel spread across an area of almost 2.61 acres and encompasses an area of 20,851.65 sq m (built-up).

Also Read: Manipal Hospitals opens 250-bed Super Specialty Hospital in Pune

As per the latest media report by Hindustan Times, the Block A hospital structure comes with a basement having 80 enclosed parking spaces and 204 mechanical stack parking spaces. It also has a lower ground, a ground floor, and three upper floors, the document showed.

For the property transaction, Manipal Hospitals had to pay around Rs 27.30 Crores as stamp duty. According to the documents, the transaction includes both the hospital building, as well as the land where it stands, Money Control has reported.

Singapore’s Temasek Holdings bought a majority stake in the Manipal Hospitals last year for $2 billion. In September 2023, Manipal Hospitals acquired a 84 per cent stake in Emami Group’s AMRI Hospitals Ltd. According to media reports, currently, the Emami Group owns a 15 per cent stake in AMRI.

Medical Dialogues had previously reported that earlier this year, Manipal Hospitals, the second largest hospital chain in India, announced the successful brand integration of three AMRI Hospitals units in Dhakuria, Mukundapur, and Salt Lake in Kolkata, which were acquired in September 2023.

Manipal Hospitals also invested in the hospital chain Medica for around Rs 1,400 crore. Back in 2021, it acquired hospital chain Columbia Asia having a portfolio of 11 healthcare facilities.

Back in 2022 Manipal Hospitals had announced the commencement of its new 250-bed hospital. Earlier this year in February, the Managing Director and CEO of Manipal Hospitals, Dilip Jose informed The Week that the Company had already two hospitals in Pune, including one in Baner. He had said, “Mumbai is also of keen interest to us, but building a greenfield hospital there is very difficult.”

Also Read: Manipal Hospitals expands footprints in East India, rebrands AMRI units

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UP: 2nd year MBBS Student hangs self over low attendance

Worried about failing due to low attendance, a second-year MBBS student of a private college allegedly committed suicide by hanging himself from the ceiling of his hostel room in Safedabad town here, police said on Monday.
The incident took place on October 11 at Hind Medical College in Safedabad, Barabanki, No suicide note was found at the spot, they said.

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Tragic: MP-based MBBS student dies in road accident in Russia, Govt requests Centre to bring back body

Chief Minister Mohan Yadav has recently assured the aggrieved family that the mortal remains of their daughter, an MBBS student who died in a tragic road accident in Russia, will be brought back.
According to IANS report, The family members said that the tragic incident occurred after the tyre of the car suddenly detached from the car causing the window to open abruptly and dashing Sharma on the ground. She was dragged for several meters and received severe injuries, including on the head, which led to her death during treatment at a hospital.
For more details, click the link below

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Study highlights need for streamlined miscarriage care in Canada

Miscarriage, or early pregnancy loss, can have devastating emotional effects, but it is poorly managed in Canada. A review published in the Canadian Medical Association Journal provides guidance to physicians on how to diagnose and manage this condition and calls for referral to outpatient early pregnancy assessment clinics (EPACs) as well as a compassionate approach.

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Countries that choose to do so can reduce premature death by half, researchers say

Since 1970, 37 countries have cut the probability of their citizens dying before they reach age 70 in half, a milestone that signals the remarkable progress many countries have made in preventing and treating disease. But a new report argues that this goal isn’t out of reach for any country that chooses to cut its premature mortality, even those afflicted by war or poverty.

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Emergency medical department study reveals half of all patients with sepsis die within two years

Half of all patients with sepsis admitted to an emergency medical department died within two years, according to Danish researchers investigating factors that could predict outcomes for these patients.

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Why some cyclists don’t wear helmets and what might convince them to wear one

Wearing a helmet can prevent brain injury and deaths in cyclists, yet many do not wear a helmet. Research presented at the European Emergency Medicine Congress suggests that this is largely due to issues of convenience and comfort.

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Clinical trials confirm zolbetuximab’s efficacy in gastric cancer

In Germany, around 17,000 people are diagnosed with gastric cancer every year. The disease is one of the leading causes of tumor-related deaths. This is due to late diagnosis and the rapid spread of tumor cells throughout the body.

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