Schmidt-Nowara W W, Meade T E, Hays M B
Department of Medicine, University of New Mexico, Albuquerque 87106.
Chest. 1991 Jun;99(6):1378-85. doi: 10.1378/chest.99.6.1378.
A dental orthosis, designed to increase the size of the upper airway by advancing the mandible, was used in 68 patients to treat snoring and varying degrees of obstructive sleep apnea. The orthosis increased the posterior airway space, as assessed by lateral cephalograms. Seven months (range 2 to 25) after beginning use, 75 percent of patients were using the orthosis regularly. Snoring, by report, was improved in all patients but one (p less than 0.001) and was eliminated in 42 percent (95 percent confidence interval 30 to 55 percent). Sleep quality and sleepiness were also reported improved. Apneas and hypopneas, measured before and after use in 20 patients with obstructive sleep apnea, were reduced from an average of 47 to 20 events per hour (p less than 0.001). Oxygenation and sleep disturbance were also improved. Apnea-hypopnea frequency was reduced with treatment to less than 20/h in 13 patients. Residual frequencies greater than 20/h were associated with higher initial frequencies of apneas and hypopneas. Side effects of orthosis use were minor, and no serious complications were observed. The dental orthosis is an effective treatment for the symptom of snoring and can also effectively treat obstructive sleep apnea of moderate severity.
一种旨在通过前移下颌来扩大上气道尺寸的牙矫治器被用于68例患者，以治疗打鼾和不同程度的阻塞性睡眠呼吸暂停。通过头颅侧位片评估，该矫治器增加了后气道间隙。开始使用7个月（范围2至25个月）后，75%的患者定期使用该矫治器。据报告，除1例患者外，所有患者的打鼾情况均有改善（p<0.001），42%的患者打鼾消失（95%置信区间为30%至55%）。睡眠质量和嗜睡情况也据报告有所改善。在20例阻塞性睡眠呼吸暂停患者使用前后进行测量，呼吸暂停和呼吸浅慢从平均每小时47次减少至20次（p<0.001）。氧合和睡眠障碍也得到改善。13例患者经治疗后呼吸暂停 - 呼吸浅慢频率降至每小时20次以下。残留频率大于每小时20次与较高的初始呼吸暂停和呼吸浅慢频率相关。使用矫治器的副作用较小，未观察到严重并发症。该牙矫治器是治疗打鼾症状的有效方法，也能有效治疗中度阻塞性睡眠呼吸暂停。
