Gotsopoulos Helen, Chen Carol, Qian Jin, Cistulli Peter A
Department of Respiratory Medicine, Centre for Sleep Disorders and Respiratory Failure, St. George Hospital, University of New South Wales, Kogarah, Australia.
Am J Respir Crit Care Med. 2002 Sep 1;166(5):743-8. doi: 10.1164/rccm.200203-208OC.
The aim of this study was to evaluate the effect of a mandibular advancement splint (MAS) on daytime sleepiness and a range of other symptoms in obstructive sleep apnea (OSA). Using a randomized crossover design, patients received 4 weeks of treatment with MAS and a control device (inactive oral appliance), with an intervening 1-week washout. At the end of each treatment period, patients were reassessed by questionnaire, polysomnography, and multiple sleep latency test. Fifty-nine men and 14 women with a mean (+/- SD) age of 48 +/- 11 years and proven OSA experienced a significantly improved mean (+/- SEM) sleep latency on the multiple sleep latency test (10.3 +/- 0.5 versus 9.1 +/- 0.5 minutes, p = 0.01) and Epworth sleepiness scale score (7 +/- 1 versus 9 +/- 1, p < 0.0001) with the MAS compared with the control device after 4 weeks. The proportion of patients with normal subjective sleepiness was significantly higher with the MAS than with the control device (82 versus 62%, p < 0.01), but this was not so for objective sleepiness (48 versus 34%, p = 0.08). Other OSA symptoms were controlled in significantly more patients with the MAS than with the control device. MAS therapy improves a range of symptoms associated with OSA.
本研究的目的是评估下颌前移矫治器（MAS）对阻塞性睡眠呼吸暂停（OSA）患者日间嗜睡及一系列其他症状的影响。采用随机交叉设计，患者接受为期4周的MAS治疗和对照装置（无活性口腔矫治器）治疗，中间间隔1周的洗脱期。在每个治疗期结束时，通过问卷调查、多导睡眠图和多次睡眠潜伏期测试对患者进行重新评估。59名男性和14名女性，平均（±标准差）年龄为48±11岁，确诊为OSA，与对照装置相比，使用MAS治疗4周后，多次睡眠潜伏期测试的平均（±标准误）睡眠潜伏期（10.3±0.5分钟对9.1±0.5分钟，p = 0.01）和Epworth嗜睡量表评分（7±1对9±1，p < 0.0001）有显著改善。与对照装置相比，使用MAS时主观嗜睡正常的患者比例显著更高（82%对62%，p < 0.01），但客观嗜睡情况并非如此（48%对34%，p = 0.08）。与对照装置相比，更多使用MAS的患者的其他OSA症状得到了控制。MAS治疗可改善一系列与OSA相关的症状。
