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在牙科诊所背景下阻塞性睡眠呼吸暂停筛查方法的比较:系统评价。

Comparison of screening methods for obstructive sleep apnea in the context of dental clinics: A systematic review.

机构信息

Department of Orthodontics, University of Alfonso X El Sabio, Madrid, Spain.

PhD Student of Faculty of Medicine, University of Salamanca, Salamanca, Spain.

出版信息

Cranio. 2023 May;41(3):245-263. doi: 10.1080/08869634.2020.1823104. Epub 2020 Sep 26.

Abstract

OBJECTIVE

To review the available bibliographic data to identify the best screening methods to detect potential obstructive sleep apnea (OSA) patients during dental clinical practice.

METHODS

Relevant studies published up to April 2020 were sourced from PubMed, Embase, MEDLINE, Cochrane, and LILACS databases.

RESULTS

Thirty studies were selected. For adults, the screening methods available to the dentist included questionnaires, scales, indexes, pulse oximetry, and anatomical factors. A combination of questionnaires is potentially the most reliable method to detect OSA risk. For children, only information on questionnaires and anatomical factors was found; two questionnaires accurately identified potential OSA risk cases. Anatomical factors also displayed a significant relation with OSA for both populations.

CONCLUSION

Dentists have a fundamental role in early detection of potential OSA cases since they can use the methods identified in this review to perform an initial screening of the population.

ABBREVIATIONS

OSA: Obstructive sleep apnea; PSG: Polysomnography; HST: Home sleep study; BMI: Body mass index; PPV: Positive predictive value; NPV: Negative predictive value; AHI: Apnea hypopnea index; RDI: Respiratory disturbance index; ODI: Oxygen desaturation index; PSQ: Pediatric Sleep Questionnaire; SRBD: Sleep-related breathing disorder; CSHQ: Children's Sleep Habits Questionnaire; ESS: Epworth Sleepiness Scale; PSQI: Pittsburgh Sleep Quality Index.

摘要

目的

回顾现有文献资料,确定在牙科临床实践中发现潜在阻塞性睡眠呼吸暂停(OSA)患者的最佳筛查方法。

方法

检索 PubMed、Embase、MEDLINE、Cochrane 和 LILACS 数据库中截至 2020 年 4 月发表的相关研究。

结果

共选择了 30 项研究。对于成年人,牙医可使用问卷、量表、指数、脉搏血氧仪和解剖因素等方法进行筛查。组合使用问卷可能是检测 OSA 风险最可靠的方法。对于儿童,仅发现了问卷和解剖因素方面的信息;有两个问卷可准确识别出潜在的 OSA 风险病例。解剖因素对于这两个群体的 OSA 也显示出显著的相关性。

结论

由于牙医可以使用本综述中确定的方法对人群进行初步筛查,因此在早期发现潜在的 OSA 病例中牙医具有重要作用。

缩写词

OSA:阻塞性睡眠呼吸暂停;PSG:多导睡眠图;HST:家庭睡眠研究;BMI:体重指数;PPV:阳性预测值;NPV:阴性预测值;AHI:呼吸暂停低通气指数;RDI:呼吸障碍指数;PSQ:儿科睡眠问卷;SRBD:睡眠相关呼吸障碍;CSHQ:儿童睡眠习惯问卷;ESS:嗜睡量表;PSQI:匹兹堡睡眠质量指数。

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