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Trans-oral robotic surgery (TORS) is increasingly employed in obstructive sleep apnoea (OSA) management. Objective outcomes are generally assessed through polysomnography. Pre-operative magnetic resonance imaging (MRI) can be a useful adjunct in objective upper airway assessment, in particular the tongue base, providing useful information for surgical planning and outcome assessment, though care must be taken in patient positioning during surgery. The purpose of this paper is to identify pitfalls in this process and suggest a protocol for pre-operative MRI scanning in OSA.

This study is a four-patient prospective case-series and literature review. Outcome measures include pre- and post-operative volumetric changes in the pharynx as measured on MRI and apnoea–hypopnea indices (AHI), with cure being OSA resolution or a 50 per cent reduction in AHI.

All patients achieved AHI reduction and/or OSA cure following TORS, despite a decrease in pharyngeal volume measurements at the tongue base level. This study and others lacked standardisation in the MRI scanning protocol, which resulted in an inability to effectively compare pre- and post-operative scans. Pitfalls were related to variation in head/tongue position, soft-tissue marker usage and assessed area boundary limits.

TORS appears to be effective in OSA management. A new protocol for patient positioning and anatomical landmarks is suggested.

The findings could provide directly comparable data between scans and may allow correlation between tongue base volumetric changes and AHI through subsequent and historical study meta-analysis.

A continuous positive airway pressure (CPAP) device is one of the main treatments for obstructive sleep apnea (OSA) patients. Most patients treated by this method complain about the comfortableness of the mask, but the commercial mask cushions are only available in fixed sizes. Therefore, the purpose of this paper is to apply the rapid tooling (RT) technique to manufacture customized nasal mask cushions, to increase the performance and with price competitiveness.

The patient's face was first duplicated twice by Hygrogum and plaster. The face model, on which the cushion CAD design was based, was digitized by the reverse‐engineering technology. The RT of the cushion was then designed and manufactured by two rapid prototyping techniques – Objet's PolyJet and shape deposition manufacturing (SDM). Finally, silicone was cast into the RT to obtain customized cushions. The customized cushion was compared with two other commercial cushions through fit testing and cost estimation.

The proposed approach can successfully manufacture customized cushions within a day. The SDM process has advantages in this application over Objet's system. The fit testing showed that the fit factor of the customized cushion was better and less loading was required, which should lead to great improvement in the patient's comfort. Moreover, the price‐to‐performance ratio of the customized cushion can be lower than the commercial ones if more than three cushions were made by a single rapid tool.

This paper has proposed a new application of RT on customized nasal mask cushions for CPAP devices. The customized cushion has lower price‐to‐performance ratio and the cost remains competitive.

The purpose is to assess the effectiveness of continuous positive airway pressure (CPAP) treatment on sleep quality, daytime sleepiness and daytime functioning among Thai obstructive sleep apnea (OSA) patients.

A repeated measures clinical intervention design was implemented. Participants were 50 patients first time diagnosed with OSA and prescribed CPAP treatment. The intervention composed of CPAP health education, and follow-up evaluation. Data on CPAP adherence were downloaded from Smartcards of the CPAP device. The Thai PSQI, ESS and FSAQ-10 questionnaires were administered at baseline, 1-month, and 3-months. Descriptive statistics and repeated measure analysis with multilevel mixed-effects modeling approach were used.

Thirty-nine participants completed the study. Approximately 53% (n = 25) and 71.1% (n = 27) of the patients adhered to CPAP treatment by the end of the 1- and 3-months, respectively. After controlling for patients’ adherence, at 1-month follow-up, the intervention improved quality of sleep (β = −2.65, 95% CI = −1.60, −4.13), daytime functioning (β = 3.24, 95% CI = 1.87, 4.61) and decreased daytime sleepiness (β = −3.29, 95% CI = −1.85, −4.73). At 3 months, the intervention still improved quality of sleep (β = −3.53, 95% CI = −2.05, −5.01), and daytime functioning (β = 4.34, 95% CI = 2.76, 5.92), and decreased daytime sleepiness (β = −4.82, 95% CI = −3.16, −6.49).

Adherence to CPAP treatment is effective in improving sleep quality, daytime functioning and reducing daytime sleepiness. Patient-oriented strategies for enhancing CPAP adherence should be developed and implemented as a standard care in sleep clinics.

Consumer well-being in health-care settings is often undermined by information asymmetries, uncertainty and complex choices. Men are generally less motivated to adopt support tools designed to facilitate shared decision-making (SDM) and increase involvement in health service delivery. This study aims to examine the effects of sports team metaphors in a male-centered decision aid on empowerment and preparedness within a sleep apnea treatment context, a common disease among men. Individual-level factors that influence the decision aid experience are also considered.

An online panel sample of 296 US men was randomly assigned to a generic or gender targeted decision aid. The scenario-based method was used to simulate the decision aid experience. A one-way MANOVA tested the effects of gender targeting on SDM-related outcomes. Structural equation modeling was then undertaken to analyze relationships between self-construal and these outcomes.

Participants who experienced the gender-targeted decision aid reported higher levels of empowerment and preparedness. The positive relationship between collective interdependence and empowerment was stronger among those who received the targeted decision aid. The positive relationship between empowerment and preparedness was also significantly stronger in the targeted group. Empowerment mediated the effect of self-construal on preparedness.

Little to no research has evaluated the effectiveness of sports team metaphors in improving SDM and facilitating health-care value cocreation. Results provide insight into how to enhance service design and delivery for men facing medical decisions.