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打鼾和阻塞性睡眠呼吸暂停:椅旁制作的下颌前伸装置的客观疗效和影响。

Snoring and Obstructive Sleep Apnea: Objective Efficacy and Impact of a Chairside Fabricated Mandibular Advancement Device.

机构信息

Toulouse Dental School, Toulouse, France.

Pneumology Centre, Perpignan, France.

出版信息

J Prosthodont. 2017 Jul;26(5):381-386. doi: 10.1111/jopr.12401. Epub 2015 Nov 30.

Abstract

PURPOSE

Obstructive sleep apnea (OSA) has been described as a common sleep respiratory disorder. Its prevalence in the adult population has been reported to be high, varying from 3% to 28%. Dental practitioners play a key role in the treatment of this disease, using tailor-made mandibular advancement devices (MADs). This pilot study assessed the efficacy and compliance of a custom-fitted thermoplastic MAD for the treatment of moderate to severe OSA syndrome.

MATERIALS AND METHODS

In this open study without a control group, OSA syndrome sufferers were enrolled by four centers. One specific MAD was custom fitted to the patients. Polysomnography, Epworth, and snoring scales were administered from inclusion to 45 days postinclusion.

RESULTS

The study population consisted of 33 men and 8 women; 35 patients completed the study. Patient response was high with 69% of them considered as responders, and 60% showing a complete response. Also, 77.3% of patients with moderate OSA syndrome presented a complete response. An improvement was observed in the apnea hypopnea index, which decreased from 34.1 ± 18.9 to 12.8 ± 14.1. The Epworth Sleepiness Scale score, snoring, and quality of sleep scores decreased with the device (p < 0.0001). Compliance rates were high, with patients wearing the device 6.5 nights a week. Side effects and patient complaints were minor and transient.

CONCLUSION

This custom-fitted MAD improved respiratory and somnolence parameters, with response rates similar to those published in the literature with other devices.

摘要

目的

阻塞性睡眠呼吸暂停(OSA)被描述为一种常见的睡眠呼吸障碍。其在成年人群中的患病率较高,报告范围为 3%至 28%。牙科医生在治疗这种疾病方面发挥着关键作用,使用定制的下颌前伸装置(MAD)。这项初步研究评估了定制热塑性 MAD 治疗中重度 OSA 综合征的疗效和顺应性。

材料和方法

在这项没有对照组的开放研究中,四个中心招募了 OSA 综合征患者。为每位患者定制了一个特定的 MAD。从纳入到纳入后 45 天,进行了多导睡眠图、嗜睡量表和打鼾量表评估。

结果

研究人群包括 33 名男性和 8 名女性;35 名患者完成了研究。患者反应率高,其中 69%的患者被认为是有反应者,60%的患者出现完全反应。此外,77.3%的中度 OSA 综合征患者出现完全反应。呼吸暂停低通气指数得到改善,从 34.1±18.9 降至 12.8±14.1。嗜睡量表评分、打鼾和睡眠质量评分随着装置的使用而降低(p<0.0001)。顺应率高,患者每周佩戴设备 6.5 晚。副作用和患者投诉轻微且短暂。

结论

这种定制的 MAD 改善了呼吸和嗜睡参数,反应率与文献中其他设备报道的相似。

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