Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.
Department of Pulmonary Medicine, Peking University People's Hospital, Beijing, China.
J Clin Sleep Med. 2021 Sep 1;17(9):1767-1776. doi: 10.5664/jcsm.9290.
Catathrenia is a rare disease, classified as isolated symptoms and normal variants under sleep-related breathing disorders in the , third edition. Because of its rarity, the research on its pathogenesis and treatment is insufficient. This study aimed to evaluate whether the mandibular advancement device (MAD) could be considered an alternative treatment trial and if so, to explore factors predicting its effectiveness.
Thirty patients (12 men and 18 women, aged 16-67 years) with catathrenia participated in the study. They underwent standard clinical evaluation, questionnaires, physical examinations, craniofacial evaluations, video polysomnography, and imaging of the upper airway before and after the insertion of the MAD. The groaning index (groaning episodes per hour of sleep) and apnea-hypopnea index were evaluated, and anatomic factors predicting effectiveness were explored.
The sleep efficiency of most patients was higher than 80%, and groaning was present throughout all stages of sleep. With the insertion of the MAD, the groaning index decreased significantly from 5.8 (2.7-14.3) to 2.8 (1.3-12.2) events/h ( = .014). Age had a negative effect on efficacy. Mandibular repositioning of the MAD, especially the amount of vertical opening and changes of the cross-sectional area of the hypopharynx, was positively related with efficacy.
The MAD could be considered a possible treatment trial for those seeking treatment for groaning.
Registry: Chinese Clinical Trial Register; Name: The etiology of catathrenia based on oral and maxillofacial system; URL: http://www.chictr.org.cn/showproj.aspx?proj=22286; Identifier: ChiCTR-COC-17013239.
Yu M, Hao Z, Xu L, Wen Y, Han F, Gao X. Mandibular advancement device as treatment trial for catathrenia (nocturnal groaning). 2021;17(9):1767-1776.
喉痉挛是一种罕见疾病，在《睡眠相关呼吸障碍分类、诊断及治疗指南》（第三版）中被归类为孤立症状和正常变异。由于其罕见性，其发病机制和治疗的研究不足。本研究旨在评估下颌前伸装置（MAD）是否可作为一种替代治疗方法，如果可以，探讨预测其疗效的因素。
30 例（男 12 例，女 18 例，年龄 16-67 岁）喉痉挛患者参与了本研究。他们在插入 MAD 前后接受了标准的临床评估、问卷调查、体格检查、颅面评估、视频多导睡眠图和上气道影像学检查。评估了呻吟指数（每小时睡眠中的呻吟发作次数）和呼吸暂停低通气指数，并探讨了预测疗效的解剖学因素。
大多数患者的睡眠效率均高于 80%，且呻吟声出现在所有睡眠阶段。随着 MAD 的插入，呻吟指数从 5.8（2.7-14.3）降至 2.8（1.3-12.2）/h（ =.014），差异有统计学意义。年龄对疗效有负面影响。MAD 的下颌重新定位，尤其是垂直开口量和下咽横截面积的变化，与疗效呈正相关。
MAD 可被视为治疗寻求治疗呻吟的患者的一种可能的治疗方法。
注册机构：中国临床试验注册中心；名称：基于口腔颌面系统的喉痉挛病因学；网址：http://www.chictr.org.cn/showproj.aspx?proj=22286；标识符：ChiCTR-COC-17013239。
于萌，郝智，徐丽，温雅，韩飞，高霞。下颌前伸装置治疗喉痉挛（夜间呻吟）[J].中华医学杂志，2021；101（9）：1767-1776.
