Departamento de Medicina, Disciplina de Pneumologia, Universidade Federal de São Paulo, São Paulo, Brazil.
Departamento de Psicobiologia, Disciplina de Medicina E Biologia Do Sono, Universidade Federal de São Paulo, São Paulo, Brazil.
Sleep Breath. 2023 Jun;27(3):991-1003. doi: 10.1007/s11325-022-02694-z. Epub 2022 Aug 10.
This study's objective was to compare the best long-term treatment, mandibular advancement device (MAD) or continuous positive airway pressure (CPAP), for patients with mild obstructive sleep apnea (OSA) in improving excessive daytime sleepiness, fatigue, mood, sustained attention, and quality of life.
This study was a single-blind, parallel, randomized clinical trial with controls. The sample was composed of individuals between 18 and 65 years of age with a body mass index of < 35 kg/m and apnea/hypopnea index above five and less than 15. Participants were submitted to physical examination, polysomnography, and the following questionnaires: Pittsburgh Sleep Quality Index, Berlin Questionnaire, Epworth Sleepiness Scale, Stanford Sleepiness Scale, Karolinska Sleepiness Scale, Modified Fatigue Impact Scale, Functional Outcomes of Sleep Questionnaire, Beck Anxiety Inventory, and Beck Depression Inventory. They were also presented with the following tests: maintenance of wakefulness test and psychomotor vigilance task.
Of 79 patients, 25 were in the MAD group, 31 in the CPAP group, and 23 in the control group. Polysomnographic parameters were best normalized with CPAP compared with MAD. Fatigue was improved in the MAD and CPAP groups, with no difference between these treatments. Quality of life was also improved with both treatments, but CPAP was superior to MAD. Daytime sleepiness, mood, and sustained attention showed no difference with the interventions. Greater adherence was obtained with MAD patients than with CPAP measured by hours of use.
Treatment with CPAP was better at normalizing polysomnographic parameters and improving quality of life in patients with mild OSA. Both treatments improved fatigue with no difference between the two treatments. Neither treatment improved daytime sleepiness, mood or sustained attention.
NTC01461486.
本研究旨在比较轻度阻塞性睡眠呼吸暂停（OSA）患者的最佳长期治疗方法，即下颌前伸装置（MAD）或持续气道正压通气（CPAP），以改善日间嗜睡、疲劳、情绪、持续注意力和生活质量。
这是一项单盲、平行、随机临床试验，设有对照组。该样本由年龄在 18 至 65 岁之间、BMI<35kg/m2、呼吸暂停/低通气指数大于 5 且小于 15 的个体组成。参与者接受了体格检查、多导睡眠图检查以及以下问卷：匹兹堡睡眠质量指数、柏林问卷、Epworth 嗜睡量表、斯坦福嗜睡量表、卡罗林斯卡嗜睡量表、改良疲劳影响量表、睡眠功能结果问卷、贝克焦虑量表和贝克抑郁量表。他们还接受了以下测试：维持清醒测试和精神运动警觉任务。
在 79 名患者中，25 名患者在 MAD 组，31 名患者在 CPAP 组，23 名患者在对照组。与 MAD 相比，CPAP 可更好地使睡眠呼吸暂停参数正常化。MAD 和 CPAP 组的疲劳均得到改善，两种治疗方法之间无差异。两种治疗方法均改善了生活质量，但 CPAP 优于 MAD。日间嗜睡、情绪和持续注意力与干预措施无关。通过使用时间测量，MAD 患者的依从性高于 CPAP 患者。
CPAP 治疗更能使轻度 OSA 患者的睡眠呼吸暂停参数正常化，并改善生活质量。两种治疗方法均可改善疲劳，两种治疗方法之间无差异。两种治疗方法均未改善日间嗜睡、情绪或持续注意力。
NTC01461486。
