Deane Sheryn A, Cistulli Peter A, Ng Andrew T, Zeng Biao, Petocz Peter, Darendeliler M Ali
Department of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney Dental Hospital, Sydney, Australia.
Sleep. 2009 May;32(5):648-53. doi: 10.1093/sleep/32.5.648.
To compare the efficacy of a mandibular advancement splint (MAS) and a novel tongue stabilizing device (TSD) in the treatment of obstructive sleep apnea (OSA).
A randomized crossover design was used.
Twenty-seven patients (20 male, 7 female), recruited from a tertiary hospital sleep clinic.
The apnea-hypopnea index (AHI) was reduced with MAS (11.68 +/- 8.94, P = 0.000) and TSD (13.15 +/- 10.77, P = 0.002) compared with baseline (26.96 +/- 17.17). The arousal index decreased for MAS (21.09 +/- 9.27, P = 0.004) and TSD (21.9 +/- 10.56, P = 0.001) compared with baseline (33.23 +/- 16.41). Sixty-eight percent of patients achieved a complete or partial response with MAS, compared with 45% with TSD. The Epworth Sleepiness Scale (ESS) score was decreased with MAS (P = < 0.001) and TSD (P = 0.002). Subjective improvements in snoring and quality of sleep were reported, with a better response for MAS than TSD. Compliance was poorer for TSD, and the side effect profiles of the 2 modalities were different. All patients were satisfied with MAS compared to TSD, and 91% of patients preferred the MAS.
Objective testing showed the MAS and TSD had similar efficacy in terms of AHI reduction. Patients reported improvements with both devices; however, better compliance and a clear preference for MAS was apparent when both devices were offered. Longer term studies are needed to clarify the role of TSD.
比较下颌前移矫治器（MAS）和新型舌稳定装置（TSD）治疗阻塞性睡眠呼吸暂停（OSA）的疗效。
采用随机交叉设计。
从一家三级医院睡眠诊所招募的27名患者（20名男性，7名女性）。
与基线水平（26.96±17.17）相比，使用MAS（11.68±8.94，P = 0.000）和TSD（13.15±10.77，P = 0.002）时呼吸暂停低通气指数（AHI）降低。与基线水平（33.23±16.41）相比，MAS（21.09±9.27，P = 0.004）和TSD（21.9±10.56，P = 0.001）的觉醒指数降低。68%的患者使用MAS时实现了完全或部分缓解，而使用TSD的患者为45%。Epworth嗜睡量表（ESS）评分使用MAS时降低（P = < 0.001），使用TSD时也降低（P = 0.002）。患者报告打鼾和睡眠质量有主观改善，MAS的反应优于TSD。TSD的依从性较差，两种方式的副作用情况不同。与TSD相比，所有患者对MAS都更满意，91%的患者更喜欢MAS。
客观测试表明，在降低AHI方面，MAS和TSD具有相似的疗效。患者报告两种装置都有改善；然而，当提供两种装置时，MAS的依从性更好且明显更受青睐。需要进行长期研究以阐明TSD的作用。
