Efficacy of daytime transcutaneous electrical stimulation of the genioglossus muscle in patients with obstructive sleep apnea syndrome: short report.

Obstructive sleep apnea syndrome (OSAS) is characterized by hypotonia of lingual and suprahyoid muscles. Genioglossus muscle is responsible for protrusion and depression of the tongue. Its dysfunction results in occlusion of the upper airways and greater incidence of apnea-hypopnea events during sleep. The aim of this prospective study was to compare the effects of daytime transcutaneous electrical stimulation of the genioglossus muscle and standard continuous positive airway pressure (CPAP) therapy on the quality of sleep, in patients with OSAS. During a 4-week study period, 19 patients with OSAS were subjected to daytime transcutaneous electrical stimulation of the genioglossus muscle before sleep and another 19 subjects underwent standard CPAP therapy. Polysomnography (apnea-hypopnea index, AHI), Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) were used to diagnose OSAS and to verify the efficacy of both treatments. Electrical stimulation treatment was reflected by a decrease in PSQI (p = 0.012) but did not influence ESS and AHI values (p > 0.05). In turn, CPAP therapy resulted in a significant decrease in ESS and AHI values (p < 0.001) but exerted no effect on PSQI (p = 0.089). Despite improvement of sleep quality, electrical stimulation does not seem to reduce AHI values in patients with OSAS. Daytime electrical stimulation can be considered as an adjunct treatment in OSAS. Future prospective studies should center on the identification of patients with OSAS who may benefit most from transcutaneous electrical stimulation.

[Excessive daytime sleepiness and risk for obstructive sleep apnea in the public transport drivers]. / Ocena wystepowania wzmozonej sennosci w ciagu dnia oraz ryzyka obturacyjnego bezdechu podczas snu u kierowców zawodowych komunikacji miejskiej.

BACKGROUND: Obstructive sleep apnea (OSA) is a set of symptoms related to the increased upper airways resistance during sleep (due to pharyngeal walls collapse) leading to intermittent airflow obstruction in the lungs. One of the most severe OSA symptoms is excessive daytime sleepiness. Sustained daytime sleepiness may impair cognitive functions and thus influence the everyday functioning of affected person. MATERIAL AND METHODS: The aim of the study was to prospectively assess excessive daytime sleepiness and the risk for OSA in municipal bus drivers. The study was performed in a group of 103 men. The anonymous survey comprised Epworth Sleepiness Scale (ESS) for daytime sleepiness assessment and STOP-Bang Questionnaire (SBQ) for OSA risk assessment. RESULTS: In 43 (42%) respondents OSA risk was assessed as low, while moderate and high risk was observed in 55 (53%) and 5 (5%) drivers, respectively. Severe daytime sleepiness correlated positively with ESS results (r = 0.32; p < 0.05). In drivers with high OSA risk revealed in SBQ no correlation with high ESS was observed. CONCLUSIONS: In drivers with moderate and high OSA risk a sleep medicine specialist consultation with a consecutive diagnostic procedures is necessary. STOP-Bang Questionnaire and ESS are the fast tools to identify patients at increased risk for OSA.

[Treatment of chronic obstructive pulmonary disease--traditional bronchodilatation and targeted anti-inflammatory therapy]. / Leczenie przewleklej obturacyjnej choroby pluc--bronchodylatacja i przeciwzapalna farmakoterapia celowana.

Currently available pharmacological treatment of COPD relies mostly on prophylaxis (smoking cessation) and symptomatic treatment, i.e. inhaled anticholinergic agents, ß2-agonists and phosphodiesterase inhibitors, aiming in their bronchodilatation capacity. Inhaled corticosteroid therapy is mainly prescribed in far advanced stages of the disease and its role in disease modification is still controversial. The authors analize currently available treatment modalities with regards to their potential anti-inflammatory and pleiotropic mode of action, which may lead to disease course modification.

Serum levels of angiopoietin-1, angiopoietin-2, and their receptor tie-2 in patients with nonsmall cell lung cancer during chemotherapy.

This pilot study was conducted to investigate the prognostic role and the effects of chemotherapy on serum angiogenic factors enzyme-linked immunosorbent assay consisting of Angiopoietin-1 and 2 (Ang-1, Ang-2) and their receptor Tie-2 in patients with advanced stage nonsmall cell lung cancer (NSCLC). Concentration of Ang-2 was higher in NSCLC (n= 40) than in healthy people (n= 15), whereas Ang-1 and Tie-2 were comparable. In our opinion determination of Ang-1, Ang-2, and Tie-2 concentrations have no clinical significance in the prognosis of the survival time in lung cancer and can not be used as a predictor of response to the chemotherapy.

[Tuberculosis pulmonum--"threaten us of epidemic"?]. / Gruzlica pluc--"czy grozi nam epidemia"?

Tuberculosis (TB) remains a deadly infectious disease affecting millions of people worldwide with 95% of cases and 98% of deaths occuring in developing countries (9 milion new cases, 1 million deaths annually) vs.WHO. Tuberculosis is on the increase in developed countries, because of AIDS, the use of immunosuppresive drugs which depress the host defence mechanism, decreased socioeconomic conditions, as well as increased immigration of persons from areas of high endemicity. The major reason for this increase was because of rapid rise in cases from sub-Saharan Africa (due to AIDS) nad Russia. Incidense of tuberculosis in Poland 2007--the number of notified cases was 8014. Pulmonary cases represented 92.7% of total all TB cases and 628 cases of extrapulmonary TB. Chidren TB cases represented 0.9% (74 cases) of all cases notified in Poland. The incidence of tuberculosis increases with age from 1.1 in children do 41.2 among 65 and older. The incidence of men (31.5) was two times higher than in women--14.5 per 100 000 respectivly. There were 716 deaths due to pulmonary TB and 23 from extrapulmonary TB. Multidrug resistance (MDR) of Mycobacterium tuberculosis is a major therapeutic problem, in the world, with a high mortality and occurs mainly in HIV-infected patients. The WHO estimates that around 50 million people are infected with MDR-TB! WHO suggest that a greater investment in the establishment treatment strategy of DOTS (Directly Observed Treatment Short-course) into all posible regions.

Serum levels of VEGF-C, VEGF-D, and sVEGF-R2 in patients with lung cancer during chemotherapy.

The aim of this study was to assess serum levels of vascular endothelial growth factor C and D (VEGF-C, VEGF-D) and soluble VEGF receptor 2 (sVEGFR-2) in patients with lung cancer during chemotherapy. The study included 80 patients (64 men and 16 women; mean age 61.1) diagnosed histologically with lung cancer. Forty-four (55%) had non-small cell lung cancer (NSCLC) and 36 (45%) had small cell lung cancer (SCLC). Squamous cell carcinoma was established in 56% (25 patients) of all patients with NSCLC, adenocarcinoma in 20% (9 patients), and non-small cell lung cancer in 23% (10 patients). The control group consisted of 20 healthy volunteers. Peripheral blood samples were taken before and after four cycles of chemotherapy. VEGF-C, VEGF-D, and sVEGFR-2 levels were assessed by ELISA method. Serum levels of VEGF-C and VEGF-D were significantly higher in both NSCLC and SCLC groups in comparison with controls. VEGF-C concentration decreased after chemotherapy, whereas VEGF-D concentration was at the same level. No correlation was found between VEGF-C and VEGF-D concentrations and the effect of treatment. Patients with lung cancer and progression after chemotherapy (PD) had the higher concentration of sVEGFR-2 than patients with partial remission (PR). The levels of sVEGFR-2 were lower before and after treatment than in controls. No relation was found between VEGF-C, VEGF-D, and sVEGFR-2 concentrations and the histological type and staging of lung cancer. Summing up, serum concentrations of VEGF-C and VEGF-D were higher in patients with lung cancer both before and after chemotherapy than in healthy controls, whereas sVEGFR-2 concentration was lower than in healthy controls. An increase in concentration of sVEGFR-2 during chemotherapy may suggest progression of the disease. However, it requires further examination.

[Histone dependent signalization during pharmacotherapy of chronic obstructive pulmonary disease]. / Sygnalizacja zalezna od histonów w farmakoterapii przewleklej obturacyjnej choroby pluc.

Chronic obstructive pulmonary disease (COPD) is a 4(th) major cause of morbidity and mortality worldwide. Cigarette smoking and oxidative/nitrosative stress leading to chronic inflammation is considered as a major cause of COPD but up to now, details of molecular pathways responsible for development of disease are unknown. Recent reports indicate the role of disruption in histone function in promoting synthesis of inflammatory cytokines through increased gene transcription which underlies disease development. Core histone acetylation/deacetylation regulate their transcription activity and drug induced changes of its intensity may be an interesting field of further research. In this article the opinions about the role of steroids as inhibitors of the inflammatory process as well as resistance to steroids have been presented. Findings from studies which aimed to explore the anti-inflammatory activity of drugs such as theophylline and N-acetylcysteine and their ability to suppress oxidative stress may suggest the usefulness of these drugs in causative treatment of COPD. However, further studies are necessary to confirm these findings.

[Posttranslational p53 phosphorylation in non small cell lung cancer cells after radio/chemotherapy]. / Potranslacyjna fosforylacja bialka p53 w komórkach niedrobnokomórkowego raka pluca po radio-i chemioterapii

INTRODUCTION: p53 protein is a critical regulator of cell cycle and apoptosis. Many stimuli change its expression and modify its functions. The aim of our work was to determine stability and chosen posttranslational modification of p53 protein during the treatment of lung cancer. MATERIAL AND METHODS: We investigated levels of poly-ADP-ribose- a marker of cellular DNA damage, DNA ploidy, Ki-67 expression, wild type and mutated p53 protein expression and intensity of phosphorylation of chosen p53 serine sites: C-terminal Ser392, and N-terminal Ser15, and Ser20 in fiberoptic bronchoscopy biopsy samples taken from patients suffering from recurrent squamous cell lung cancer before and after radio/chemotherapy. Analysis was based on results obtained from 23 patients after surgery in I-IIIA clinical stage of the disease. RESULTS: Therapy lowered the number of G2/M cells, but increased S fraction cell population in about 50%. Therapy increased p53 expression and p53 phosphorylation at Ser392 and Ser20, and these changes correlated with poly-ADP-ribose levels and Ki-67 expression. CONCLUSIONS: Our results indicate that apart from changes in p53 quantity, p53 posttranslational phosphorylation play a role in regulation of neoplastic cells proliferation in response to drugs.

Serum levels of IGF-I and IGFBP-3 in patients with lung cancer during chemotherapy.

The aim of this study was to assess serum levels of insulin-like growth factors (IGF-I and IGFBP-3) in patients with lung cancer during chemotherapy. The study included 38 patients (33 males and 5 females; mean age 59.8) diagnosed histologically with lung cancer. Twenty-five patients (65%) had non-small cell lung cancer (NSCLC) and 13 patients (35%) had small cell lung cancer (SCLC). Squamous cell carcinoma was established in 30% (11 patients) of all patients with NSCLC, adenocarcinoma in 13% (5 patients), and non-small cell cancer in 36% (9 patients). The control group consisted of 10 healthy volunteers. Peripheral blood samples were taken before and after four cycles of chemotherapy. IGF-I and IGFBP-3 levels were assessed by ELISA method. Serum levels of IGF-I measured before chemotherapy were significantly higher in both NSCLC and SCLC groups in comparison with controls. No significant differences were observed in serum IGF-I levels before and after four cycles of chemotherapy. The levels were still high after chemotherapy in patients with NSCLC and SCLC. Serum levels of IGFBP-3 were markedly lower in patients with NSCLC both before and after treatment compared to controls. No significant differences were found in patients with NSCLC before and after cytoreduction treatment. Prior to treatment, serum IGFBP-3 levels were significantly lower in patients with SCLC in comparison with controls. After cytoreduction treatment, the levels were decreased when compared to controls but without statistical significance. In conclusion, both before and after chemotherapy serum levels of IGF-I were significantly higher, whereas IGFBP-3 levels were lower in patients with NSCLC and SCLC compared to controls. Chemotherapy had no influence on the serum levels of IGF-I and IGFBP-3. Neither a histological type of NSCLC nor clinical staging had any effect on the serum levels of IGF-I and IGFBP-3.

[Stenting central airways with tracheobronchial stents]. / Protezowanie tchawicy i duzych oskrzeli z zastosowaniem stentów tchawiczo-oskrzelowych.

Tracheobronchial stenting is indicated in the palliative care of cancer patients with central airways obstruction due to primary chest and neck tumors, metastatic and congenital lesions of these organs. Stents, tubular prostheses, solid or wired, removable or not, of different shape, size, material, are used to treat airway obstructions due to endobronchial overgrowing, infiltration, compression, or relaxation of the airway walls. Silicone stents are well tolerated and removable. Their limitations are: the mucociliary clearance impairment, thick walls, displacement possibility. Rigid bronchoscopy is required for insertion of the prosthesis. Metal stents allow mucociliary transport, exactly match the trachea or bronchus dimension and are insertable with the bronchofiberscope. Attempts of self-absorbed stents application in the course of tracheobronchomalacia and post surgical bronchial wall collapse are being made. The choice of the type of the stent used is made on the basis of personnel experience, type and localisation of the obstruction, clinical status and accompanying diseases.

[Pathogenesis of chronic obstructive pulmonary disease. Molecular mechanisms (part II)]. / Patogeneza przewleklej obturacyjnej choroby pluc. Czesc II. Podloze molekularne.

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. Smoking is considered the major cause of the disease. Relatively little is known about the molecular mechanisms underlying inflammatory response in smokers' lungs and how this relates to the susceptibility to the disease, particularly why only 10-15% of smokers develop COPD. Recent development in molecular biology techniques allowed the insight into the inner space of the cell, to the levels far beyond the reach of the traditional methods. We review recent hypotheses on cellular and molecular background of COPD with emphasis on the potential role of histone acetylation, as a key modulator of enhanced gene transcription responsible for proinflammatory cytokines production in COPD. Authors propose a role for modification of nucleosomal structure in inflammatory cytokine gene transcription in response to smoking. Cigarette smoke causes oxidative stress altering the balance between histone deacetylation and acetylation in favor of acetylation. This can contribute to the airflow obstruction in smokers susceptible to the development of COPD. Furthermore, histone acetylation seems to be a potential mechanism exclusive to smokers with susceptibility to COPD based on the transcription of specific pro- and anti-inflammatory cytokine combinations.

[Pathogenesis of chronic obstructive pulmonary disease. Cellular mechanisms (part I)]. / Patogeneza przewleklej obturacyjnej choroby pluc. Czesc i. podloze komórkowe.

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. Smoking is considered the major cause of the disease. All smokers develop airway inflammation through oxidative stress with macrophages, neutrophiles, lymphocytes, eosinophils, NK-cells and mediators involved. Macrophages through the activation of Nuclear Factor kappa B (NF.-kappaB) release proinflammatory mediators, lymphocyte chemotactic agents and elastolytic enzymes, activate neutrophil driven serine proteases and GM-CSF. Neutrophiles release IL-8 which in turn recruits neutrophils to the airways. In response to cigarette smoke lung epithelium may release TNF-alpha, TGF-beta, IL-1beta, GM-CSF, IL-8 reactive oxygen species (ROS). Increased number of lymphocyte T CD8+ and CD4+ subpopulations may lead to lung epithelium cells apoptosis and necrosis through perphorines and granzyme-B and TNF-alpha activation. Moreover, increased expression of IL-6, IL-10, IL-12, IL-13, and INF-gamma is observed. Authors indicate the possibility of new treatment strategies such as: agents directed against adhesion molecules, chemokines, phosphodiesterase 4, p38 MAPK, NF.-kappaB phosphoinositide-3-kinase gamma, TGF-beta, NOS synthase, serine proteinases and matrix metalloproteinases.

[Expression of L-selectin on the surface of neutrophils stimulated by TNF-alpha and level of sL-selectin in serum of patients with lung cancer]. / Ocena ekspresji czasteczki adhezyjnej L-selektyny na powierzchni neutrofilów krwi obwodowej stymulowanych TNF-alpha oraz stezenia rozpuszczalnej formy selektyny w surowicy u chorych na raka pluca.

The aim of the study was to estimate L-selectin expression on peripheral blood PMN stimulated by TNF-alpha and concentration of a soluble form of L-selectin in serum of patients with small cell and non-small cell lung cancer. The results showed an increased expression of L-selectin on PMN isolated from peripheral blood and an elevated concentration of sL-selectin in serum of patients with small cell and non-small cell lung cancer. An increased expression of these adhesion molecules may be the result of neutrophil activation by inflammatory cytokines.

[The effect of fenspiride on the number of exacerbations and the time of first exacerbation in patients with chronic bronchitis]. / Wplyw fenspirydu na liczbe zaostrzen i czas ich wystapienia u chorych na przewlekle zapalenie oskrzeli.

UNLABELLED: The aim of the work was evaluation of efficacy of fenspiride b.i.d. on the number of exacerbations and the time to the first exacerbation in patients with chronic bronchitis. MATERIAL AND METHODS: Randomized, multicentre study controlled versus placebo was carried out in 12 centers in Poland. All patients, 89 females and 68 males aged between 20 and 74, were treated with fenspiride at the dose of 160 mg/day for a period of 6 months. The following symptoms were recorded every month in order to evaluate the therapeutic efficacy: sputum quality and quantity, cough intensity, dyspnea and bronchospasm. Based on these symptoms diagnosis of exacerbation was performed according to American Thoracic Society criteria. RESULTS: Quality and quantity of sputum and cough significantly improved in the fenspiride group (comparing to the placebo group p= 0.027 and p = 0.049 adequately for sputum and cough). A significant difference between groups was observed in the number of exacerbation episodes and their duration. In the fenspiride group there were 0.53 episodes of exacerbation compared with 1.12 episodes in the placebo group (p = 0.038). Mean duration of exacerbation was 3.3 days in the fenspiride group and 7.3 days in the placebo treated patients (p = 0.034). Time to the first exacerbation differed between groups, but this difference was not statistically significant. Number of side effects observed did not differ between groups. CONCLUSION: Fenspiride treatment was assessed as relatively effective in terms of influence on exacerbations, and well tolerated during six month therapy.

[Evaluation of some functions of polymorphonuclear granulocytes in lung cancer patients during chemotherapy]. / Ocena niektórych funkcji granulocytów obojetnochlonnych u chorych na raka pluca leczonych lekami cytoredukcyjnymi.

Lung cancer (NSCLC and SCLC) is one of most frequent carcinoma. Lung cancer is at the top of the list of cancers causing mortality in males. Many patients are qualified to chemotherapy which causes neutropenia. The aim of this work was to evaluate the number and function of (phagocytosis, test of NBT reduction and MPO activity) of leukocytes in patients with lung cancer before chemotherapy, during leukopenia and after stimulation with granulocyte colony stimulating factor (G-CSF). Patients with lung cancer have increased number of leukocytes before the treatment. After chemotherapy the number of leukocytes decreases. Treatment with G-CSF increases the number of leukocytes but it doesn't increase their ability to phagocytosis and to NBT reduction.

The epidemiology of asbestos-related diseases.

Asbestos has been recognised as a potential health hazard since the 1940s. Of the two major species of asbestos; white asbestos (chrysotile) and blue asbestos (crocidolite), both of which are hazardous. The workers at extraction facilities are at the greatest risk of exposure to asbestos and, therefore, the development of asbestos-related diseases, commonly mesothelioma. However, other individuals at a high risk of exposure include asbestos-cement workers, insulation workers and ship-yard workers. Environmental exposure to asbestos can occur as a result of living in areas either characterised by natural outcrops of asbestos or asbestos-related materials, or those close to asbestos-producing or -using plants. Unfortunately, man-made fibre alternatives to asbestos, such as rock and slag-wool and glass wool, have also been shown to have a detrimental effect on human health. A characteristic of mesothelioma is that there is a long latency period (20-30 years) before the signs and symptoms of the disease become apparent. In addition, diagnosis of the disease can be difficult. The use of biological markers, such as tissue polypeptide antigen, may play a useful role in the early detection of the disease in individuals at risk.

[Expression of adhesion molecules LFA-1 and L-selectin on PMN and level of soluble sE-selectin and sL-selectin in the serum of patients with small cell lung cancer]. / Ocena ekspresji czasteczek adhezyjnych LFA-1 i L-selektyny na neutrofilach krwi obwodowej oraz poziomu rozpuszczalnych form L-selektyny i E-selektyny u chorych na drobnokomórkowego raka pluca.

The aim of this study was to estimate expression of adhesion molecules LFA-1 and L-selectin on PMN of peripheral blood, and level of soluble sE-selectin and sL-selectin in the serum of 16 patients with small cell lung cancer (SCLC) before treatment. We observed significantly higher expression of LFA-1 and L-selectin on PMN in comparison to healthy persons and higher level sE selectin and sL selectin in the serum of SCLC patients. Increasing of adhesion molecules expression on PMN can lead to damage of neoplasmatic cells and may be one of the reasons for create a new cancer sites as well.

[Circulating VEGF and its soluble receptor sVEGFR-1 in patients with lung cancer]. / Naczyniowo-sródblonkowy czynnik wzrostu--VEGF i rozpuszczalny receptor--sVEGFR-1 w surowicy chorych na raka pluca.

Angiogenesis plays an important role in the pathogenesis of lung cancer. This process is caused by the imbalance between stimulating and inhibiting agents. VEGF is a key stimulator having a biologic effect via two different receptors of tyrosine kinase: VEGF-R1 and VEGF-R2. A soluble form of sVEGF-R1 is a negative regulator of VEGF activity. The serum concentrations of VEGF, sVEGF-R1 were assayed in 24 patients with NSCLC and 13 patients with SCLC and 10 healthy volunteers by means of ELISA method. The serum concentrations of VEGF were significantly higher in patients than in controls (p=0.016). The concentration of sVEGF-R1 was not significantly different in patients and controls. No statistically significant differences were established between the concentrations of VEGF, and sVEGF-R1 with regard to such clinical features, as: performance staging, clinical staging (stage III vs. stage IV) and histological pattern (NSCLC vs. SCLC). The significantly higher VEGF concentrations were reported in patients with the tumor of more than 7.5 cm in the diameter (p=0.027). Analyzing the influence of the response to treatment on the concentrations of parameters examined, a significant increase in VEGF concentration was demonstrated in the case of disease progression (p=0.034). The concentrations of sVEGF-R1 did not change after treatment. No correlation was found between parameters examined.

[Comparison of cellular composition of induced sputum, bronchial washings and bronchoalveolar lavage fluid in sarcoidosis, hypersensitivity pneumonitis and COPD]. / Porównanie skladu komórkowego indukowanej plwociny, popluczyn oskrzelowych i plynu z plukania oskrzelowo-pecherzykowego w sarkoidozie, alergicznym zewnatrzpochodnym zapaleniu pecherzyków plucnych i przewleklej obturacyjnej chorobie pluc.

UNLABELLED: This study compares the cellular profiles of induced sputum (IS), bronchial washing (BW), and BAL fluid (BAL) in newly diagnosed sarcoidosis (BBS) and hypersensitivity pneumonitis (HP) patients to COPD group, and examines whether inflammatory cell counts from IS correlated with inflammatory cell counts from BW and BAL in sarcoidosis and HP patients. METHODS: We recruited 23 untreated patients with stage II pulmonary sarcoidosis, 15 untreated patients with HP and 17 COPD patients. Sputum was induced with hypertonic saline solution in all individuals. Bronchoscopy was performed on a different occasions in all patients. RESULTS: Mean lymphocyte counts in IS, BW, and BAL fluid from sarcoidosis and HP patients were significantly higher than in COPD subjects (8.9% and 13.8 vs 2.9%, p < 0.05; 11.9% and 30.5 vs 3.2%, p < 0.05; 21.5% and 56 vs 3.4%, p < 0.05, respectively). Moreover we found higher percentage of CD4+, CD3+ CD28+, CD3+ HLADRV+, and gamma delta T cells in IS, BW, and BAL fluid from both BBS and HP groups than in from COPD. Elevated CD4/CD8 ratio characterized IS, BW and BAL fluid in BBS group. Strong correlation IS/BAL and IS/BW of CD3+ CD28+, CD3+ HLADRV+, and CD4/CD8 ratio was found. CONCLUSIONS: We demonstrated that, although the relative proportion of inflammatory cells differed in the three samples, lymphocyte counts in IS were high. This finding suggests that IS could be used as a valuable alternative method to more conventional invasive techniques in clinical assessment of interstitial lung diseases patients.

Rehabilitation of patients with obstructive sleep apnea syndrome.

The current treatment of obstructive sleep apnea syndrome (OSAS) focuses on alleviation of symptoms by increasing airway patency during sleep through positive airway pressure, oral appliances, changes in sleep position, weight loss, or surgical treatment. Continuous positive airway pressure (CPAP) is currently the treatment of choice and prevents upper airway obstruction, resulting in improved sleep architecture and daytime symptoms. Despite proven efficacy, adherence to CPAP treatment is still not efficient. The new methods of rehabilitation (exercise training programs, hypoglossal nerve stimulation) for patients with OSAS are currently modified. The aim of the present study was to present recent developments in the field of selected aspects of rehabilitation in patients with OSAS. Database search was focused on exercise training programs and electrostimulation of genioglossus muscle. The search for articles on the rehabilitation interventions for OSAS was performed using the PubMed database from 1966 to 2013. Most of the findings have shown beneficial effects of rehabilitation. In detail, we describe the recent developments and potential adverse effects of electrostimulation and physical exercises. According to the results of studies presented, the above therapy might support conventional treatment or may be an alternative for patients with poor compliance to CPAP therapy, mandibular advancement devices, or ineffective results of surgical procedures as well.