Nikolopoulou Maria, Ahlberg Jari, Visscher Corine M, Hamburger Hans L, Naeije Machiel, Lobbezoo Frank
Department of Oral Kinesiology, Academic Centre for Dentistry, Amsterdam, The Netherlands.
J Orofac Pain. 2013 Summer;27(3):199-205. doi: 10.11607/jop.967.
To assess the influence of occlusal stabilization splints on sleep-related respiratory variables in obstructive sleep apnea (OSA) patients.
Ten OSA patients (47.3 ± 11.7 years of age) received a stabilization splint in the maxilla. All patients underwent three polysomnographic recordings with their splint in situ, and three recordings without their splint in situ, using a randomized crossover design.
Repeated-measures ANOVAs did not yield statistically significant differences in the Apnea-Hypopnea Index (AHI) or in the Epworth Sleepiness Scale (ESS), neither between the three nights without the stabilization splint (AHI: F = 2.757, P = .090; ESS: F = 0.153, P = .860) nor between the nights with the splint in situ (AHI: F = 0.815, P = .458; ESS: F = 0.231, P = .796). However, independent ANOVAs revealed that the mean AHI of the three nights with the stabilization splint in situ (17.4 ± 7.0 events/hour) was significantly higher than that of the nights without the splint in situ (15.9 ± 6.4 events/hour) (F = 7.203, P = .025). The mean increase in AHI with the splint in situ was 1.4 ± 1.7 (95% confidence interval = -1.9-4.7). No difference in ESS was found when both conditions were compared (F = 1.000, P = .343).
The use of an occlusal stabilization splint is associated with a risk of aggravation of OSA; however, the effect size was small, which reduces the clinical relevance of the study.
评估咬合稳定夹板对阻塞性睡眠呼吸暂停(OSA)患者睡眠相关呼吸变量的影响。
10名OSA患者(年龄47.3±11.7岁)上颌佩戴稳定夹板。所有患者采用随机交叉设计,在佩戴夹板时进行3次多导睡眠图记录,不佩戴夹板时也进行3次记录。
重复测量方差分析显示,在无稳定夹板的三个夜晚之间(呼吸暂停低通气指数[AHI]:F = 2.757,P = 0.090;爱泼沃斯思睡量表[ESS]:F = 0.153,P = 0.860)以及佩戴夹板时的夜晚之间(AHI:F = 0.815,P = 0.458;ESS:F = 0.231,P = 0.796),AHI或ESS均无统计学显著差异。然而,独立方差分析显示,佩戴稳定夹板时三个夜晚的平均AHI(17.4±7.0次/小时)显著高于不佩戴夹板时的夜晚(15.9±6.4次/小时)(F = 7.203,P = 0.025)。佩戴夹板时AHI的平均增加量为1.4±1.7(95%置信区间=-1.9 - 4.7)。比较两种情况时,ESS未发现差异(F = 1.000,P = 0.343)。
使用咬合稳定夹板与OSA加重风险相关;然而,效应量较小,这降低了该研究的临床相关性。