Nakai Takayuki, Matsuo Akira, Takata Yoshifumi, Usui Yasuhiro, Kitamura Koichi, Chikazu Daichi
a Departments of Oral and Maxillofacial Surgery , Tokyo Medical University , Tokyo , Japan.
b Department of Oral and Maxillofacial Surgery , Ibaraki Medical Center Tokyo Medical University , Ibaraki , Japan.
Acta Odontol Scand. 2018 Nov;76(8):605-611. doi: 10.1080/00016357.2018.1495841.
Obstructive sleep apnea (OSA) is a significant social and health issue. An integrated multidisciplinary approach to OSA management may be the most effective owing to its multifactorial etiology. In this study, we evaluated the frequency and efficacy of various treatment modalities for OSA administered via an integrated care delivery model, and assessed the role of dental sleep medicine as part of a multidisciplinary team.
We retrospectively evaluated 1115 patients with OSA treated at the Tokyo Medical University Hospital's Outpatient Clinic for OSA by a multidisciplinary team under one roof. The various treatment methods included the following: continuous positive airway pressure (CPAP), oral appliance (OA), surgery, and behavioral treatment.
The patient number of study group was as follows: 771 (69.1%) CPAP; 240 (21.5%) OA; 76 (6.8%) behavioral treatment and 28 (3%) surgery. Because significantly fewer patients underwent surgery, there was a discrepancy between the recommended first-choice treatment and the actual treatment. A statistically significant number of younger patients in each treatment group underwent surgery. Success rate of OA and MMA were 74.4 and 80%, respectively.
Proper selection of primary treatment to manage patients with OSA was possible under one-roof system that included dental sleep medicine.
阻塞性睡眠呼吸暂停（OSA）是一个重大的社会和健康问题。由于其病因多因素，采用综合多学科方法管理OSA可能是最有效的。在本研究中，我们评估了通过综合护理模式给予OSA的各种治疗方式的频率和疗效，并评估了牙科睡眠医学作为多学科团队一部分的作用。
我们回顾性评估了东京医科大学医院门诊OSA多学科团队在同一屋檐下治疗的1115例OSA患者。各种治疗方法包括：持续气道正压通气（CPAP）、口腔矫治器（OA）、手术和行为治疗。
研究组患者数量如下：771例（69.1%）采用CPAP；240例（21.5%）采用OA；76例（6.8%）采用行为治疗；28例（3%）采用手术。由于接受手术的患者明显较少，推荐的首选治疗与实际治疗之间存在差异。每个治疗组中接受手术的年轻患者数量在统计学上具有显著意义。OA和MMA的成功率分别为74.4%和80%。
在包括牙科睡眠医学的同一屋檐下系统中，对OSA患者进行适当的初始治疗选择是可行的。
