Haviv Y, Bachar G, Aframian D J, Almoznino G, Michaeli E, Benoliel R
Department of Oral Medicine, Hebrew University - Hadassah School of Dental Medicine, Jerusalem, Israel.
Oral Dis. 2015 Apr;21(3):386-92. doi: 10.1111/odi.12291. Epub 2014 Oct 28.
Oral appliances for treating severe obstructive sleep apnea (OSA) are recommended for patients who failed to comply with continuous positive airway pressure (CPAP) treatment. The objective of this study was to evaluate medium long-term outcome and success rates of oral appliances in patients with severe OSA.
In a retrospective study, 52 OSA patients with an apnea-hypopnea index (AHI) ≥40, who did not tolerate CPAP treatment, were enrolled and fitted with a modified Herbst oral appliance. A 2-year mean follow-up including a second somnography was conducted in 36 of the patients.
A significant reduction (P < 0.0001) in the AHI was demonstrated between the initial somnography (55.25 ± 10.79,) and the followed one (17.74 ± 11.0, n = 36). Overall, 57.7% of total study subjects (n = 52) and 63.9% (n = 36) that had sequential sonmogarphy continued using the device. The reduction in AHI in the user group was 42.4 ± 3.1 (n = 23), which was significantly higher (P = 0.013) than in the non-user group (28.9 ± 17.2; n = 13). Moreover, 53% (n = 19) reached AHI of <15.
Oral appliances were found to be successful for treating for severe OSA after first-line treatment had failed.
对于那些未能坚持持续气道正压通气（CPAP）治疗的患者，推荐使用口腔矫治器治疗重度阻塞性睡眠呼吸暂停（OSA）。本研究的目的是评估口腔矫治器治疗重度OSA患者的中长期疗效和成功率。
在一项回顾性研究中，纳入了52例呼吸暂停低通气指数（AHI）≥40且不耐受CPAP治疗的OSA患者，并为其佩戴改良的Herbst口腔矫治器。对其中36例患者进行了为期2年的平均随访，包括第二次睡眠监测。
初始睡眠监测时（55.25±10.79）与随访时（17.74±11.0，n = 36）相比，AHI显著降低（P < 0.0001）。总体而言，整个研究对象（n = 52）中有57.7%，以及进行了连续睡眠监测的患者（n = 36）中有63.9%继续使用该装置。使用者组的AHI降低值为42.4±3.1（n = 23），显著高于非使用者组（28.9±17.2；n = 13）（P = 0.013）。此外，53%（n = 19）的患者AHI降至<15。
在一线治疗失败后，发现口腔矫治器治疗重度OSA是成功的。
