Berg Lars M, Ankjell Torun K S, Sun Yi-Qian, Trovik Tordis A, Sjögren Anders, Rikardsen Oddveig G, Moen Ketil, Hellem Sølve, Bugten Vegard
Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
ENT Department, University Hospital of Northern Norway, Tromsø, Norway.
Int J Otolaryngol. 2020 Mar 19;2020:6459276. doi: 10.1155/2020/6459276. eCollection 2020.
Nonsevere obstructive sleep apnea (OSA) is most often treated with a continuous positive airway pressure (CPAP) device or a mandibular advancement splint (MAS). However, patient compliance with these treatments is difficult to predict. Improvement in apnea-hypopnea index (AHI) is also somewhat unpredictable in MAS treatment. In this study, we investigated the association between Friedman tongue position score (Friedman score) and both treatment compliance and AHI improvement in patients with nonsevere OSA receiving CPAP or MAS treatment. 104 patients with nonsevere OSA were randomly allocated to CPAP or MAS treatment and followed for 12 months. Data were collected through a medical examination, questionnaires, sleep recordings from ambulatory type 3 polygraphic sleep recording devices, and CPAP recordings. Associations between Friedman score, treatment compliance, and AHI improvement were analysed with logistic regression analyses. Friedman score was not associated with treatment compliance (odds ratio [OR]: 0.85, 95% confidence interval [CI]: 0.59-1.23), or AHI improvement (OR: 1.05, 95% CI: 0.62-1.76) in the overall study sample, the CPAP treatment group, or the MAS treatment group. Adjustment for socioeconomic factors, body mass index, and tonsil size did not significantly impact the results. Although Friedman score may predict OSA severity and contribute to the prediction of success in uvulopalatopharyngoplasty, we found no association between Friedman score and treatment compliance in patients with nonsevere OSA receiving CPAP or MAS treatment, nor did we find any association between Friedman score and AHI improvement. Factors other than Friedman score should be considered when deciding whether a patient with nonsevere OSA should be treated with CPAP or MAS.
非重度阻塞性睡眠呼吸暂停（OSA）最常采用持续气道正压通气（CPAP）设备或下颌前移矫治器（MAS）进行治疗。然而，患者对这些治疗方法的依从性难以预测。在MAS治疗中，呼吸暂停低通气指数（AHI）的改善也具有一定的不可预测性。在本研究中，我们调查了Friedman舌位评分（Friedman评分）与接受CPAP或MAS治疗的非重度OSA患者的治疗依从性及AHI改善之间的关联。104例非重度OSA患者被随机分配接受CPAP或MAS治疗，并随访12个月。通过体格检查、问卷调查、便携式3型多导睡眠记录设备的睡眠记录以及CPAP记录收集数据。采用逻辑回归分析来分析Friedman评分、治疗依从性和AHI改善之间的关联。在整个研究样本、CPAP治疗组或MAS治疗组中，Friedman评分与治疗依从性（优势比[OR]：0.85，95%置信区间[CI]：0.59 - 1.23）或AHI改善（OR：1.05，95% CI：0.62 - 1.76）均无关联。对社会经济因素、体重指数和扁桃体大小进行调整后，结果无显著影响。虽然Friedman评分可能预测OSA的严重程度，并有助于预测悬雍垂腭咽成形术的成功率，但我们发现接受CPAP或MAS治疗的非重度OSA患者中，Friedman评分与治疗依从性之间无关联，Friedman评分与AHI改善之间也无关联。在决定非重度OSA患者是否应采用CPAP或MAS治疗时，应考虑Friedman评分以外的其他因素。
