Raunio Antti, Mattila Pauli, Huuskonen Usko, Oikarinen Kyösti, Sándor George K
Department of Oral and Maxillofacial Surgery, Medical Research Center, Oulu University Hospital, Oulu Finland.
J Oral Maxillofac Res. 2015 Mar 30;6(1):e4. doi: 10.5037/jomr.2014.6104. eCollection 2015 Jan-Mar.
The purpose of this study was to investigate the effect of a mandibular advancement device on different grades of obstructive sleep apnea using a relatively simple test for the apnea-hypopnea index to determine if a mandibular device will be effective.
A total of 68 patients with obstructive sleep apnea syndrome (OSAS) including, 31 with mild, 23 with moderate and 14 with severe OSAS were treated with a mandibular advancement device (MAD) and monitored with polysomnography.
25 of the 31 mild, 15 of the 23 moderate and 2 of the 14 severe OSAS patients were cured of their OSAS if a post treatment apnea-hypopnea index of less than 5 is regarded as cured. The odds ratios for success with MAD therapy are 3 for women over men, 14.9 for mild obstructive sleep apnea, 5.42 for moderate obstructive sleep apnea if severe obstructive sleep apnea is assigned an odds ratio of 1.
The use of the apnea-hypopnea index alone is useful in mild and moderate disease to predict the effectiveness of mandibular advancement device. Treatment with a mandibular advancement device is very effective in treating mild and moderate obstructive sleep apnea. Conservative treatment with a mandibular advancement device can be successful in less severe grades of sleep apnea and may be an alternative for non-surgical patients with severe obstructive sleep apnea intolerant of Continuous Positive Airway Pressure management.
本研究旨在使用一种相对简单的呼吸暂停低通气指数测试方法，研究下颌前移装置对不同程度阻塞性睡眠呼吸暂停的影响，以确定下颌装置是否有效。
共有68例阻塞性睡眠呼吸暂停综合征（OSAS）患者，其中轻度31例、中度23例、重度14例，接受下颌前移装置（MAD）治疗，并进行多导睡眠图监测。
如果将治疗后呼吸暂停低通气指数小于5视为治愈，那么31例轻度OSAS患者中有25例、23例中度患者中有15例、14例重度患者中有2例被治愈。MAD治疗成功的优势比，女性相对于男性为3，轻度阻塞性睡眠呼吸暂停为14.9，中度阻塞性睡眠呼吸暂停为5.42（重度阻塞性睡眠呼吸暂停的优势比设定为1）。
仅使用呼吸暂停低通气指数在轻度和中度疾病中有助于预测下颌前移装置的有效性。下颌前移装置治疗轻度和中度阻塞性睡眠呼吸暂停非常有效。下颌前移装置的保守治疗在不太严重的睡眠呼吸暂停程度中可能成功，并且对于不耐受持续气道正压通气管理的重度阻塞性睡眠呼吸暂停非手术患者可能是一种替代方法。
