Non-ablative treatment of sleep breathing disorders with the association of two high-intensity pulsed lasers

Abstract

Primary snoring and obstructive sleep apnea (OSA) represent different severity degrees of the same chronic, complex and progressive disease, which affects about one billion people worldwide. It is more prevalent in elderly men. Historically, snoring is seen as a social problem, being considered the most benign form of sleep breathing disorders (SBD). Because of this, treatment is not prescribed. Snoring noise occurs as a result of soft tissue vibration in the region of upper airway (UA) greater constriction during sleep. Therapeutic options may involve medical treatments, use of devices, and surgical procedures. As for the results, all of them have limitations. Adherence to treatment and cases of relapse over time represent the greatest challenge in disease control. Increased cardiovascular risk, emergence of chronic diseases and use of medications result from worsening and disease progression. A dysregulation of palatopharyngeal muscle tone plays a significant role in this disorder. After determining the best irradiation conditions, this study aims to evaluate the treatment of SBD with high intensity non-ablative irradiation with two pulsed lasers: Nd:YAG laser (1064 nm) followed by Er:YAG laser (2940 nm), both from Fotona LightWalker platform, comparing results before and after the intervention. A controlled, randomized, double-blind clinical trial was performed with approval of the research ethics committee. Thirty volunteers that transitioned between primary snoring and moderate obstructive sleep apnea were treated in three sessions of non-ablative laser irradiation, with a 14-day interval between them. The upper airway lumen for airflow passage was analyzed by photographic record, according to modified Mallampati index. Oxyhemoglobin desaturation parameters, severity of snoring (noise amplitude and sleep time with snoring) as well as aspects of sleep quality were also evaluated. The main clinical result obtained is the expansion of the upper airways lumen by reduction of tissue compliance in an outpatient procedure. Therefore, improvement of sleep breathing disorder.