比较老年人无牙颌轻、中、重度阻塞性睡眠呼吸暂停患者上气道的解剖和气流动力学特征。
Comparison of anatomic and aerodynamic characteristics of the upper airway among edentulous mild, moderate, and severe obstructive sleep apnea in older adults.
机构信息
Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University and Shandong Key Laboratory of Oral Tissue Regeneration and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Shandong, China.
Faculty of Dental Medicine, University of Montreal, Montreal, Quebec, Canada.
出版信息
J Clin Sleep Med. 2022 Mar 1;18(3):759-768. doi: 10.5664/jcsm.9716.
STUDY OBJECTIVES
First, to compare the upper airway's anatomic and aerodynamic characteristics of the edentulous older adults who experience mild, moderate, and severe obstructive sleep apnea (OSA). Second, to examine the correlation between the severity of OSA and the anatomic and aerodynamic characteristic(s) of the upper airway in these edentulous individuals.
METHODS
NewTom5G cone beam computed tomography scans of 58 edentulous individuals with mild, moderate, and severe OSA were included in this analysis. 1) Computational models of the upper airway were reconstructed based on cone beam computed tomography images and the anatomical and aerodynamic characteristics of the upper airway were examined by an observer blind to OSA severity. 2) Pearson correlation analysis was used to determine the correlation between apnea-hypopnea index and the anatomic and aerodynamic characteristics of the upper airway.
RESULTS
Compared with edentulous patients with mild and moderate OSA, those with severe OSA have a more hourglass-shaped upper airway. The severity of OSA, namely, apnea-hypopnea index, was significantly correlated with the length, shape, and minimum cross-sectional area of the upper airway. During inspiration, the mean velocity of the airflow within the upper airway of the edentulous patients with severe OSA was higher than that of patients with mild and moderate OSA. During both inspiration and expiration, apnea-hypopnea index was found to be significantly correlated with maximum velocity ( = .05) and airway resistance ( = .024, 0.038).
CONCLUSIONS
The edentulous patients with severe OSA have a more hourglass-shaped upper airway. The findings also suggest that, during inspiration, the airflow travels faster in edentulous patients with severe OSA than in those with mild or moderate OSA.
CLINICAL TRIAL REGISTRATION
Registry: ClinicalTrials.gov; Name: The Effect of Nocturnal Wear of Dentures on Sleep and Oral Health Related Quality of Life; URL: https://clinicaltrials.gov/ct2/show/NCT01868295; Identifier: NCT01868295.
CITATION
Chen H, Elham E, Li Y, et al. Comparison of anatomic and aerodynamic characteristics of the upper airway among edentulous mild, moderate, and severe obstructive sleep apnea in older adults. . 2022;18(3):759-768.
研究目的
首先，比较轻度、中度和重度阻塞性睡眠呼吸暂停（OSA）的无牙老年患者的上气道解剖和空气动力学特征。其次，研究这些无牙个体中 OSA 的严重程度与上气道解剖和空气动力学特征之间的相关性。
方法
本研究纳入了 58 例无牙个体的 NewTom5G 锥形束 CT 扫描，这些个体患有轻度、中度和重度 OSA。1）根据锥形束 CT 图像重建上气道的计算模型，并由一位对 OSA 严重程度不知情的观察者检查上气道的解剖和空气动力学特征。2）采用 Pearson 相关分析确定呼吸暂停低通气指数与上气道解剖和空气动力学特征之间的相关性。
结果
与轻度和中度 OSA 的无牙患者相比，重度 OSA 的患者上气道呈更沙漏形。OSA 的严重程度，即呼吸暂停低通气指数，与上气道的长度、形状和最小横截面积显著相关。在吸气过程中，重度 OSA 无牙患者上气道内气流的平均速度高于轻度和中度 OSA 患者。在吸气和呼气过程中，呼吸暂停低通气指数与最大速度（ =.05）和气道阻力（ =.024，0.038）显著相关。
结论
重度 OSA 的无牙患者上气道呈更沙漏形。研究结果还表明，在吸气过程中，重度 OSA 无牙患者的气流速度快于轻度或中度 OSA 患者。
临床试验注册
注册号：ClinicalTrials.gov；名称：夜间佩戴义齿对睡眠和口腔健康相关生活质量的影响；网址：https://clinicaltrials.gov/ct2/show/NCT01868295；标识符：NCT01868295。
引文
Chen H, Elham E, Li Y, et al. Comparison of anatomic and aerodynamic characteristics of the upper airway among edentulous mild, moderate, and severe obstructive sleep apnea in older adults.. 2022;18(3):759-768.
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