Department of Prosthodontics, Medical University of Warsaw, 59 Nowogrodzka Street, Bldg.XIa, Warsaw, 02-006, Poland.
Fourth Clinic of Lung Diseases, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland.
Adv Exp Med Biol. 2018;1040:39-46. doi: 10.1007/5584_2017_101.
Obstructive sleep apnea (OSA) is defined as episodes of upper airway obstructions during sleep. The method of choice in conservative treatment of OSA is the use of devices that produce positive airway pressure (CPAP). In patients with mild-moderate form of OSA, intraoral mandibular advancement devices (MAD) are applied. The aim of the study was to evaluate the therapeutic efficacy of MAD in patients with severe OSA who were unable to use CPAP. In this preliminary study three patients from a group of 25 severe OSA sufferers who failed to use CPAP, were included. The three patients underwent a triple polysomnographic (PSG) investigation: on CPAP, before MAD treatment, and during MAD. The patients completed the Epworth Sleepiness Scale questionnaire twice. We found significant improvements of subjective symptoms and PSG-evaluated variables after application of MAD in all three patients in comparison with both baseline and CPAP-recorded data. We conclude that MAD can be an alternative treatment option for severe OSA patients who are non-compliant with CPAP therapy.
阻塞性睡眠呼吸暂停（OSA）被定义为睡眠期间上呼吸道阻塞的发作。保守治疗 OSA 的首选方法是使用产生正压气道（CPAP）的设备。对于轻中度 OSA 患者，应用口腔下颌前伸装置（MAD）。本研究旨在评估无法使用 CPAP 的重度 OSA 患者 MAD 的治疗效果。在这项初步研究中，从 25 名无法使用 CPAP 的重度 OSA 患者中选择了 3 名患者。这 3 名患者接受了三次三重多导睡眠图（PSG）检查：CPAP、MAD 治疗前和 MAD 治疗期间。患者两次完成 Epworth 嗜睡量表问卷。与基线和 CPAP 记录的数据相比，我们发现所有 3 名患者在应用 MAD 后主观症状和 PSG 评估变量均有显著改善。我们得出结论，MAD 可以作为对 CPAP 治疗不依从的重度 OSA 患者的替代治疗选择。
