Postgraduate Studies & Research, Saraswati Dental College & Hospital, Lucknow, India.
Department of Prosthodontics, Saraswati Dental College & Hospital, Lucknow, India.
J Prosthodont. 2019 Feb;28(2):e843-e848. doi: 10.1111/jopr.12654. Epub 2017 Aug 21.
To estimate the incidence of obstructive sleep apnea (OSA) in elderly edentulous patients (aged 60-65 years) and investigate a correlation of serum serotonin levels with the apnea-hypopnea index (AHI), respiratory effort-related arousal (RERA), and respiratory disturbance index (RDI).
381 elderly completely edentulous patients (307 male, 74 female) aged 60 to 65 years with a history of edentulism of 12 to 15 months, seeking oral rehabilitation at the prosthodontic clinic at Saraswati Dental College & Hospital, Lucknow, India, between January 2014 and January 2016 were enrolled for the present study. After application of the inclusion and exclusion criteria of this study, 183 patients (162 male, 21 female) who were found susceptible, were subjected to the BERLIN questionnaire and Epworth Sleepiness Scale (ESS) to assess sleep disordered breathing (SDB) and then put through all-night polysomnography (PSG). On the basis of AHI, RERA, and RDI scores, 156 patients (143 male, 13 female) who tested positive for OSA were classified according to its intensity. All 156 patients underwent body-mass index (BMI) estimation, cephalometry, and intraoral examination for skeletal and soft tissue profile record. Serum serotonin was estimated from whole blood samples for the 156 OSA and the 27 normal patients. The 156 (147 nonobese, 9 obese) OSA-positive patients were provided with complete dentures and were trained to use the same as a modified mandibular advancement device (MAD) during sleep at night. These patients were kept on a quarterly follow-up for 9 months. Data collected was subjected to statistical analysis, and inferences drawn.
The incidence of OSA in elderly edentulous subjects was found to be 32.03% in males and 8.91% in females. A mere 9 out of 156 (5.76%) elderly edentulous OSA patients were found to be obese (Class I) on the basis of BMI estimation. Cephalometry of the patients showed that they had a skeletal class I maxillomandibular relationship. AHI scores of nonobese patients revealed that most of the patients had moderate OSA, followed by mild OSA and severe OSA. Serum serotonin levels ranged from 53 to 83 ng/dL. AHI score of the 9 obese patients were in the moderate to severe range, and their serum serotonin levels were 60 to 70 ng/dL. A correlation between severity of OSA and serum serotonin level was validated in this study.
OSA was found to be prevalent in edentulous subjects due to pharyngeal collapse and decreased neuromuscular control. An inverse relationship of serum serotonin levels and AHI scores was established.
评估 60-65 岁老年无牙患者（60-65 岁）阻塞性睡眠呼吸暂停（OSA）的发生率，并研究血清 5-羟色胺水平与呼吸暂停低通气指数（AHI）、呼吸相关觉醒（RERA）和呼吸紊乱指数（RDI）的相关性。
本研究纳入了 2014 年 1 月至 2016 年 1 月期间在印度勒克瑙 Saraswati 牙科学院和医院修复科寻求口腔修复的 381 名 60-65 岁、无牙、无牙病史 12-15 个月的老年完全无牙患者（男 307 例，女 74 例）。在本研究的纳入和排除标准应用后，发现 183 名（男 162 名，女 21 名）患者易患睡眠呼吸障碍，对其进行 BERLIN 问卷和 Epworth 嗜睡量表（ESS）评估睡眠呼吸障碍（SDB），然后进行整夜多导睡眠图（PSG）检查。根据 AHI、RERA 和 RDI 评分，对 156 名（男 143 名，女 13 名）OSA 阳性患者进行分类，根据其严重程度进行分类。所有 156 名 OSA 患者和 27 名正常患者均进行了体重指数（BMI）评估、头影测量和口腔内检查，以记录骨骼和软组织形态。从全血样本中估算了 156 名 OSA 和 27 名正常患者的血清 5-羟色胺水平。156 名（非肥胖 147 名，肥胖 9 名）OSA 阳性患者被提供了全口义齿，并在夜间作为改良下颌前伸装置（MAD）使用进行睡眠训练。这些患者在 9 个月内每季度进行一次随访。对收集的数据进行了统计分析和推断。
男性老年无牙患者 OSA 的发生率为 32.03%，女性为 8.91%。仅 9 名（5.76%）老年无牙 OSA 患者根据 BMI 估计为肥胖（I 类）。患者的头影测量显示他们具有骨骼 I 类上颌下颌关系。非肥胖患者的 AHI 评分显示，大多数患者患有中度 OSA，其次是轻度 OSA 和重度 OSA。血清 5-羟色胺水平在 53-83ng/dL 之间。9 名肥胖患者的 AHI 评分处于中重度范围，其血清 5-羟色胺水平为 60-70ng/dL。本研究验证了 OSA 严重程度与血清 5-羟色胺水平之间的相关性。
由于咽腔塌陷和神经肌肉控制下降，无牙患者中 OSA 较为常见。建立了血清 5-羟色胺水平与 AHI 评分的负相关关系。
