Disserta????o
Non-ablative treatment of sleep breathing disorders with the association of two high-intensity pulsed lasers
Tratamento n??o-ablativo dos dist??rbios respirat??rios do sono com associa????o de dois lasers pulsados de alta intensidade: Nd:YAG e Er:YAG
Autor
MENDES, VALERIA
Resumen
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. Conselho Nacional de Desenvolvimento Cient??fico e Tecnol??gico (CNPq) Funda????o de Amparo ?? Pesquisa do Estado de S??o Paulo (FAPESP) Disserta????o (Mestrado Profissional em Tecnologia das Radia????es em Ci??ncias da Sa??de) IPEN/D-MP Instituto de Pesquisas Energ??ticas e Nucleares - IPEN-CNEN/SP CNPq: SISFOTON 440228/2021-2; INCT INFO 465763/2014-6 FAPESP: 17/50332-0