McGown A D, Makker H K, Battagel J M, L'Estrange P R, Grant H R, Spiro S G
Dept of Thoracic Medicine, University College London Hospitals, UK.
Eur Respir J. 2001 Mar;17(3):462-6. doi: 10.1183/09031936.01.17304620.
A mandibular advancement splint (MAS) may be an alternative treatment for snoring and obstructive sleep apnoea (OSA). However, there is little subjective or objective information concerning long-term effectiveness, compliance and side effects. A retrospective questionnaire was used to survey these issues plus patient satisfaction and maintenance requirements in 166 patients who could have worn a mandibular advancement splint for over a year. One-hundred and twenty-six (76%) subjects returned the questionnaire, (84 with OSA, 42 snorers), of whom 69 (55%) reported still using the splint regularly, 47 (37%) every night. The most common reported reasons for stopping use were discomfort (29/ 57; 52%) of nonusers), and poor perceived efficacy (12 subjects). Users reported more daytime symptoms, and they and their partners were more likely to observe improvements with splint use. Side effects were reported by 49 subjects, more commonly in nonusers. Sixty-five of 67 current users and 23 of 41 nonusers reported less snoring with splint use (p = < 0.001). Long-term mandibular advancement splint usage appeared less satisfactory than previously reported, however, splints were considered effective by 97% of current users and even by over half of those who had stopped use. Reasons for stopping use included side effects, social circumstances, dental treatment, as well as lack of perceived efficacy.
下颌前移矫治器(MAS)可能是治疗打鼾和阻塞性睡眠呼吸暂停(OSA)的一种替代疗法。然而,关于其长期疗效、依从性和副作用的主观或客观信息却很少。我们采用回顾性问卷调查的方式,对166例可能已佩戴下颌前移矫治器一年以上的患者的这些问题以及患者满意度和维护需求进行了调查。126名(76%)受试者回复了问卷(84例患有OSA,42例打鼾者),其中69名(55%)报告仍在定期使用矫治器,47名(37%)每晚都用。报告的停止使用的最常见原因是不适(29/57;非使用者中的52%)和感觉疗效不佳(12名受试者)。使用者报告了更多的日间症状,他们及其伴侣更有可能观察到使用矫治器后有所改善。49名受试者报告了副作用,更多见于非使用者。67名现使用者中的65名和41名非使用者中的23名报告使用矫治器后打鼾减轻(p =<0.001)。长期使用下颌前移矫治器的效果似乎不如先前报道的那样令人满意,然而,97%的现使用者甚至超过一半已停止使用的人都认为矫治器是有效的。停止使用的原因包括副作用、社会情况、牙科治疗以及感觉疗效不佳。