Bandyopadhyay Anuja, Kaneshiro Kellie, Camacho Macario
Clinical Pediatrics Section of Pediatric Pulmonology, Allergy and Sleep Medicine Riley Hospital for Children at Indiana University Health, 705 Riley Hospital Drive, ROC 4270, Indianapolis, IN, 46202-5225, USA.
Library Technology, Ruth Lily Medical Library, USA.
Sleep Med. 2020 Nov;75:210-217. doi: 10.1016/j.sleep.2020.08.003. Epub 2020 Aug 10.
To systematically review the current literature for articles describing the effect of myofunctional therapy on pediatric obstructive sleep apnea (OSA) and to perform a meta-analysis on the sleep study data.
Three authors (A.B., K.K. and M.C.) independently searched from inception through April 20, 2020 in PubMed/MEDLINE, Scopus, Embase, Google Scholar and The Cochrane Library. Mean difference (MD), standard deviations and 95% confidence intervals were combined in the meta-analysis for apnea-hypopnea index (AHI), mean oxygen saturations, and lowest oxygen saturations (nadir O2).
10 studies with 241 patients met study criteria and were further analyzed. The AHI reduced from 4.32 (5.2) to 2.48 (4.0) events/hr, a 43% reduction. Random effects modeling demonstrated a mean difference in AHI of -1.54 (95% CI -2.24,-0.85)/hr, z-score is 4.36 (p < 0.0001). Mean oxygen saturation increased by 0.37 (95% CI 0.06,0.69) percent, z-score is 2.32 (p = 0.02). There was no significant increase in nadir O2.
Despite heterogeneity in exercises, myofunctional therapy decreased AHI by 43% in children, and increased mean oxygen saturations in children with mild to moderate OSA and can serve as an adjunct OSA treatment.
系统回顾当前文献中描述肌功能治疗对小儿阻塞性睡眠呼吸暂停（OSA）影响的文章，并对睡眠研究数据进行荟萃分析。
三位作者（A.B.、K.K.和M.C.）从创刊至2020年4月20日在PubMed/MEDLINE、Scopus、Embase、谷歌学术和考克兰图书馆进行独立检索。在荟萃分析中合并了呼吸暂停低通气指数（AHI）、平均血氧饱和度和最低血氧饱和度（最低O2）的平均差（MD）、标准差和95%置信区间。
10项研究共241例患者符合研究标准并进一步分析。AHI从4.32（5.2）次/小时降至2.48（4.0）次/小时，降低了43%。随机效应模型显示AHI的平均差为-1.54（95%CI -2.24，-0.85）/小时，z值为4.36（p<0.0001）。平均血氧饱和度增加了0.37（95%CI 0.06，0.69）%，z值为2.32（p=0.02）。最低O2无显著增加。
尽管运动方式存在异质性，但肌功能治疗可使儿童AHI降低43%，并提高轻度至中度OSA儿童的平均血氧饱和度，可作为OSA的辅助治疗方法。
