睡眠呼吸暂停与职业事故：口腔矫治器是解决之道吗？

Sleep apnea and occupational accidents: Are oral appliances the solution?

作者信息

Rabelo Guimarães Maria De Lourdes, Hermont Ana Paula

机构信息

Faculty of Dentistry of the Federal University of Minas Gerais, Belo Horizonte, Brazil.

Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

出版信息

Indian J Occup Environ Med. 2014 May;18(2):39-47. doi: 10.4103/0019-5278.146887.

DOI:10.4103/0019-5278.146887

PMID:25568596

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4280775/

Abstract

BACKGROUND

Dental practitioners have a key role in the quality of life and prevention of occupational accidents of workers with Obstructive Sleep Apnea Syndrome (OSAS).

AIM

The aim of this study was to review the impact of OSAS, the Continuous Positive Airway Pressure (CPAP) therapy, and the evidence regarding the use of oral appliances (OA) on the health and safety of workers.

MATERIALS AND METHODS

Searches were conducted in MEDLINE (PubMed), Lilacs and Sci ELO. Articles published from January 1980 to June 2014 were included.

RESULTS

The research retrieved 2188 articles and 99 met the inclusion criteria. An increase in occupational accidents due to reduced vigilance and attention in snorers and patients with OSAS was observed. Such involvements were related to excessive daytime sleepiness and neurocognitive function impairments. The use of OA are less effective when compared with CPAP, but the results related to excessive sleepiness and cognitive performance showed improvements similar to CPAP. Treatments with OA showed greater patient compliance than the CPAP therapy.

CONCLUSION

OSAS is a prevalent disorder among workers, leads to increased risk of occupational accidents, and has a significant impact on the economy. The CPAP therapy reduces the risk of occupational accidents. The OA can improve the work performance; but there is no scientific evidence associating its use with occupational accidents reduction. Future research should focus on determining the cost-effectiveness of OA as well as its influence and efficacy in preventing occupational accidents.

摘要

背景

牙科医生在阻塞性睡眠呼吸暂停综合征（OSAS）患者的生活质量和职业事故预防方面起着关键作用。

目的

本研究旨在综述阻塞性睡眠呼吸暂停综合征（OSAS）、持续气道正压通气（CPAP）治疗以及口腔矫治器（OA）使用的相关证据对工人健康和安全的影响。

材料与方法

在MEDLINE（PubMed）、Lilacs和SciELO数据库中进行检索。纳入1980年1月至2014年6月发表的文章。

结果

检索到2188篇文章，99篇符合纳入标准。观察到打鼾者和阻塞性睡眠呼吸暂停综合征（OSAS）患者因警觉性和注意力下降导致职业事故增加。这些情况与白天过度嗜睡和神经认知功能损害有关。与持续气道正压通气（CPAP）相比，口腔矫治器（OA）的效果较差，但与白天过度嗜睡和认知表现相关的结果显示出与持续气道正压通气（CPAP）相似的改善。口腔矫治器（OA）治疗的患者依从性高于持续气道正压通气（CPAP）治疗。

结论

阻塞性睡眠呼吸暂停综合征（OSAS）在工人中是一种普遍存在的疾病，会增加职业事故风险，并对经济产生重大影响。持续气道正压通气（CPAP）治疗可降低职业事故风险。口腔矫治器（OA）可改善工作表现；但尚无科学证据表明其使用与减少职业事故有关。未来的研究应侧重于确定口腔矫治器（OA）的成本效益及其在预防职业事故中的影响和疗效。