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阻塞性睡眠呼吸暂停综合征患者日间颏舌肌经皮电刺激的疗效:简短报告

Efficacy of daytime transcutaneous electrical stimulation of the genioglossus muscle in patients with obstructive sleep apnea syndrome: short report.

作者信息

Chwieśko-Minarowska Sylwia, Minarowski Łukasz, Szewczak Wojciech Aleksander, Chyczewska Elżbieta, Kuryliszyn-Moskal Anna

机构信息

Department of Rehabilitation, Medical University of Bialystok, M. Sklodowska-Curie 24A St, 15-276, Bialystok, Poland.

Department of Lung Diseases and Tuberculosis, Medical University of Bialystok, Bialystok, Poland.

出版信息

Eur Arch Otorhinolaryngol. 2016 Nov;273(11):3891-3895. doi: 10.1007/s00405-016-4047-9. Epub 2016 Apr 13.

Abstract

Obstructive sleep apnea syndrome (OSAS) is characterized by hypotonia of lingual and suprahyoid muscles. Genioglossus muscle is responsible for protrusion and depression of the tongue. Its dysfunction results in occlusion of the upper airways and greater incidence of apnea-hypopnea events during sleep. The aim of this prospective study was to compare the effects of daytime transcutaneous electrical stimulation of the genioglossus muscle and standard continuous positive airway pressure (CPAP) therapy on the quality of sleep, in patients with OSAS. During a 4-week study period, 19 patients with OSAS were subjected to daytime transcutaneous electrical stimulation of the genioglossus muscle before sleep and another 19 subjects underwent standard CPAP therapy. Polysomnography (apnea-hypopnea index, AHI), Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) were used to diagnose OSAS and to verify the efficacy of both treatments. Electrical stimulation treatment was reflected by a decrease in PSQI (p = 0.012) but did not influence ESS and AHI values (p > 0.05). In turn, CPAP therapy resulted in a significant decrease in ESS and AHI values (p < 0.001) but exerted no effect on PSQI (p = 0.089). Despite improvement of sleep quality, electrical stimulation does not seem to reduce AHI values in patients with OSAS. Daytime electrical stimulation can be considered as an adjunct treatment in OSAS. Future prospective studies should center on the identification of patients with OSAS who may benefit most from transcutaneous electrical stimulation.

摘要

阻塞性睡眠呼吸暂停综合征(OSAS)的特征是舌肌和舌骨上肌群张力减退。颏舌肌负责舌头的前伸和下压。其功能障碍会导致上气道阻塞,并增加睡眠期间呼吸暂停低通气事件的发生率。这项前瞻性研究的目的是比较日间经皮颏舌肌电刺激与标准持续气道正压通气(CPAP)疗法对OSAS患者睡眠质量的影响。在为期4周的研究期间,19例OSAS患者在睡前接受日间经皮颏舌肌电刺激,另外19例受试者接受标准CPAP疗法。采用多导睡眠图(呼吸暂停低通气指数,AHI)、爱泼沃斯思睡量表(ESS)和匹兹堡睡眠质量指数(PSQI)来诊断OSAS并验证两种治疗方法的疗效。电刺激治疗表现为PSQI降低(p = 0.012),但不影响ESS和AHI值(p > 0.05)。相反,CPAP疗法使ESS和AHI值显著降低(p < 0.001),但对PSQI没有影响(p = 0.089)。尽管睡眠质量有所改善,但电刺激似乎并不能降低OSAS患者的AHI值。日间电刺激可被视为OSAS的辅助治疗方法。未来的前瞻性研究应聚焦于确定哪些OSAS患者可能从经皮电刺激中获益最大。

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