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咬合稳定夹板对阻塞性睡眠呼吸暂停的影响:一项随机对照试验。

Effects of occlusal stabilization splints on obstructive sleep apnea: a randomized controlled trial.

作者信息

Nikolopoulou Maria, Ahlberg Jari, Visscher Corine M, Hamburger Hans L, Naeije Machiel, Lobbezoo Frank

机构信息

Department of Oral Kinesiology, Academic Centre for Dentistry, Amsterdam, The Netherlands.

出版信息

J Orofac Pain. 2013 Summer;27(3):199-205. doi: 10.11607/jop.967.

Abstract

AIMS

To assess the influence of occlusal stabilization splints on sleep-related respiratory variables in obstructive sleep apnea (OSA) patients.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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