Apnea affects a large percentage of the population; it is debilitating and has considerable economic impact. Accurate diagnosis via polysomnography is technically difficult, expensive, and inconvenient. Treatment is via positive air-pressure, unacceptable to a high percentage of patients, surgical intervention, limited success and irreversibly invasive, and removable/adjustable mandibular and tongue repositioning devices. Innovative techniques for low cost diagnostic screening, treatment planning and evaluation, especially aids to design and evaluation of repositioning devices, would broaden accessibility of diagnosis and therapy through increased capacity of present clinical resources and reduce cost to patient and third party insurers.Clinical Imaging has developed prototype software for upper airway analysis which partially addresses these needs. The software visualizes and quantifies the airway via sagittal and cross-sectional images. Obstructions and restrictions are easily located; this information could indicate conservative treatment. Airway dilation using jaw and tongue repositioning devices can be located and quantified; this information could indicate minimum advancement required to reduce apnea symptoms. Innovative information is provided by a "local air- flow index" which may indicate "functional" (turbulent flow) obstructions.Aims of Phase I are to simplify operation of the software and obtain pilot data relevant to its clinical application. Phase II will include research to validate clinical efficacy, and extend imaging to sleeping patients.National Institute of Neurological Disorders and Stroke (NINDS)
