Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
Private practice, Athens, Greece.
Am J Orthod Dentofacial Orthop. 2023 Aug;164(2):276-284. doi: 10.1016/j.ajodo.2022.12.017. Epub 2023 Mar 30.
The study aimed to assess (1) the effect of the treatment with cervical headgear on patients' sleep-related attributes and well-being and (2) whether these sleep-related parameters (ie, sleep quality and quantity) were associated with patients' compliance during the orthodontic treatment.
The study protocol was based on a prospective longitudinal quasi-experimental design. Participants (n = 26; 9 males; mean age, 12.4 ± 1.68 years) were patients in the Postgraduate Orthodontic Clinic, National and Kapodistrian University of Athens. All patients received treatment with a cervical headgear having an embedded TheraMon microsensor. Sleep was assessed by wrist-worn actigraphy for 59 ± 19 days. The Epworth Sleepiness Scale was used to assess average daytime sleepiness, whereas we used the Athens Insomnia Scale for insomnia symptoms. Oral health-related quality of life (OHRQOL) was assessed by the Oral Health Impact Profile (OHIP-14).
Patients slept on average 7.35 ± 0.42 h/d. Compared with the lowest sleep duration recommended for their age group, patients had an average chronic sleep deficit of 1.40 ± 0.49 h/d. Patients wore the headgear 90.9% of the days for 10.40 ± 4.17 h/d. However, only 7 (28%) patients reached or exceeded the wear-time recommendation of 12 h/d. In contrast, 2 (8%) patients wore headgear <5 h/d, 11 (44%) 5-10 h/d, and 12 (48%) patients wore headgear >10 h/d. Aggregated by participants, the median Epworth Sleepiness Scale score during the study was 3.40 (interquartile range [IQR], 4.85; range, 0.2-13.6), the median Athens Insomnia Scale score was 3.00 (IQR, 4.25; range, 0-7), and the median Oral Health Impact Profile score was 1.40 (IQR, 4.17; range, 0.0-20.8). Compared with patients who wore the orthodontic appliance >7.8 h/d, patients who wore it <7.8 h/d had worse average daytime sleepiness (P = 0.050) and worse OHRQOL (P = 0.019).
Orthodontic treatment with cervical headgear has no substantive negative effect on sleep attributes (quantity and quality), average daytime sleepiness and OHRQOL. However, poor compliance with orthodontic treatment seems to be associated with higher levels of daytime sleepiness.
本研究旨在评估 (1) 颈椎头帽治疗对患者睡眠相关属性和健康的影响，以及 (2) 这些睡眠相关参数（即睡眠质量和数量）是否与患者在正畸治疗期间的依从性相关。
研究方案基于前瞻性纵向准实验设计。参与者（n=26；9 名男性；平均年龄 12.4±1.68 岁）是雅典国立卡波迪斯特里亚大学研究生正畸诊所的患者。所有患者均接受颈椎头帽治疗，该头帽内置有 TheraMon 微传感器。使用腕戴活动记录仪评估 59±19 天的睡眠。使用 Epworth 嗜睡量表评估平均日间嗜睡，使用雅典失眠量表评估失眠症状。使用口腔健康相关生活质量 (OHRQOL) 量表口腔健康影响量表 (OHIP-14) 进行评估。
患者平均每天睡眠 7.35±0.42 小时。与推荐的最适合其年龄组的最低睡眠时间相比，患者平均慢性睡眠不足 1.40±0.49 小时/天。患者每天佩戴头帽 90.9%的时间为 10.40±4.17 小时/天。然而，只有 7（28%）名患者达到或超过了 12 小时/天的佩戴时间建议。相比之下，2（8%）名患者每天佩戴头帽<5 小时，11（44%）名患者每天佩戴头帽 5-10 小时，12（48%）名患者每天佩戴头帽>10 小时。综合所有参与者的数据，研究期间的中位 Epworth 嗜睡量表评分为 3.40（四分位距 [IQR]，4.85；范围，0.2-13.6），中位雅典失眠量表评分为 3.00（IQR，4.25；范围，0-7），中位口腔健康影响量表评分为 1.40（IQR，4.17；范围，0.0-20.8）。与每天佩戴正畸矫治器>7.8 小时的患者相比，每天佩戴时间<7.8 小时的患者日间嗜睡程度更严重（P=0.050），口腔健康相关生活质量更差（P=0.019）。
颈椎头帽正畸治疗对睡眠属性（数量和质量）、平均日间嗜睡和口腔健康相关生活质量没有实质性的负面影响。然而，正畸治疗依从性差似乎与日间嗜睡程度较高有关。
