Guimarães Maria de Lourdes Rabelo, Azevedo Pedro Guimarães, Barros-Vieira Sérgio, Elbaz Maxime, Leger Damien, Hermont Ana Paula
Universidade Federal de Minas Gerais, Faculty of Medicine, Belo Horizonte, Brazil, - Belo Horizonte - Minas Gerais - Brazil.
UNISONO- Centre de Diagnostique et Traitement des Troubles du Sommeil, - Vitória - Espírito Santo - Brazil.
Sleep Sci. 2022 Jan-Mar;15(Spec 1):135-142. doi: 10.5935/1984-0063.20220012.
A cross-sectional study was designed to evaluate the effectiveness of a mandibular advancement device (MAD) with respect to respiratory and sleep parameters among miners with obstructive sleep apnea syndrome (OSAS) and primary snore.
The target sample was composed by 102 Brazilian miners with a history of non-adherence to continuous positive airway pressure. All patients were treated with a MAD and underwent pre and post-treatment full-night polysomnography. Ethical approval and consents were obtained. Bivariate and logistic regression analyses were conducted. The level of statistical significance was set at 5%.
After the treatment with MAD, 71.8% of patients presented a decrease ≥ 50% in the basal apnea-hypopnea index (AHI), 51.2% presented an AHI < 5 events/h and 83.3% reached an AHI<10/h, whereas 22.5% did not show any changes and 7.5% of the sample presented an increase in the AHI (p<0.05). There was an increase in the mean SpO2 nadir (p<0.001) and in the baseline duration of the REM sleep stage (p<0.05). The MAD significantly decreased snore events (p<0.05). Multivariate analysis did not identify predictive factors related to therapy success (decrease ≥ 50% of AHI). However, basal AHI was a significant predictor related to the secondary endpoint (AHI<10/h) (OR= 1.06, IC 95%1.00-1.13, p=0.007).
The MAD therapy showed significant improvements in AHI, minimum oxygen saturation, REM sleep and snoring.
设计一项横断面研究，以评估下颌前移装置（MAD）对患有阻塞性睡眠呼吸暂停综合征（OSAS）和原发性打鼾的矿工的呼吸和睡眠参数的有效性。
目标样本由102名有不坚持持续气道正压通气病史的巴西矿工组成。所有患者均接受MAD治疗，并在治疗前后进行整夜多导睡眠图检查。获得了伦理批准和知情同意。进行了双变量和逻辑回归分析。统计学显著性水平设定为5%。
使用MAD治疗后，71.8%的患者基础呼吸暂停低通气指数（AHI）下降≥50%，51.2%的患者AHI<5次/小时，83.3%的患者AHI<10次/小时，而22.5%的患者没有任何变化，7.5%的样本AHI增加（p<0.05）。平均最低血氧饱和度（p<0.001）和快速眼动睡眠阶段的基线持续时间增加（p<0.05）。MAD显著减少了打鼾事件（p<0.05）。多变量分析未发现与治疗成功（AHI下降≥50%）相关的预测因素。然而，基础AHI是与次要终点（AHI<10次/小时）相关的显著预测因素（OR=1.06，95%置信区间1.00-1.13，p=0.007）。
MAD治疗在AHI、最低氧饱和度、快速眼动睡眠和打鼾方面显示出显著改善。
