Petitjean T, Chammas N, Langevin B, Philit F, Robert D
Laboratoire des Troubles Respiratoires liés au Sommeil, Hôpital de la Croix-Rousse, Lyon, France.
Sleep. 2000 Jun 15;23 Suppl 4:S166-71.
Mandibular advancement device (MAD) represents a therapeutic option for simple snoring to obstructive sleep apnea syndrome (OSAS). The different available studies report an improvement either on nocturnal respiratory events or on the quality of sleep. The decrease in the intensity of snoring is confirmed by the patient's partner and by objective studies. For the time being the effects of these mandibular advancement devices on the upper airway resistance syndrome has not yet been well documented. The significant clinical improvement is secondary to the decrease in apnea hypopnea index (AHI). A polysomnographically proved cure has been reported with AHI < 10/h. Sleep architecture is also improved with wearing MAD demonstrating a decrease in the time passed in stage 1 sleep and an increase in slow wave sleep and rapid eye movement sleep (REM). A decrease in microarousals index has been shown. Daytime vigilance disorders are subjectively and objectively less remarkable. Then MAD can be beneficial for mild to moderate SAOS.
下颌前移装置（MAD）是一种治疗单纯性打鼾至阻塞性睡眠呼吸暂停综合征（OSAS）的治疗选择。不同的现有研究报告了夜间呼吸事件或睡眠质量的改善。患者伴侣和客观研究证实了打鼾强度的降低。目前，这些下颌前移装置对上气道阻力综合征的影响尚未得到充分记录。显著的临床改善继发于呼吸暂停低通气指数（AHI）的降低。有报告称，多导睡眠图证实治愈时AHI<10/小时。佩戴MAD也改善了睡眠结构，表现为1期睡眠的时间减少，慢波睡眠和快速眼动睡眠（REM）增加。微觉醒指数也有所下降。白天的警觉障碍在主观和客观上都不那么明显。因此，MAD对轻度至中度SAOS可能有益。
