Department of Research, Örebro University Hospital, Region Örebro County and Faculty of Medicine Health, Örebro University, Örebro, Sweden.
Region Västmanland - Uppsala University, Centre for Clinical Research, Västmanland Hospital, Västerås, Sweden.
Sleep Breath. 2024 Aug;28(4):1723-1730. doi: 10.1007/s11325-024-03019-y. Epub 2024 May 21.
Although overall success rates for treating obstructive sleep apnea (OSA) with an oral appliance (OA) are high, they are significantly higher among females. To verify published data, the study's purpose was to evaluate a participant sample after one year of OA use. The primary outcome was treatment response, with responders defined as having an apnea-hypopnea index (AHI) < 10 at follow-up and/or reduced by ≥50% of baseline. Secondary measures were from standardized questionnaires.
A sample of 314 participants, predominately with moderate-to-severe OSA, were enrolled and instructed to use an OA every night. At baseline and one-year follow-up, polygraphic recordings and questionnaires, including sleepiness (measured using the Epworth sleepiness scale) and quality-of-life (measured using the Functional Outcomes of Sleep Questionnaire), were collected.
Among the 314 participants, 192 completed the one-year evaluation: 51 females (27%) and 141 males (73%). Overall, OA treatment resulted in 78% and 77% responders among females and males, respectively. Neither the difference in improvement nor the absolute change in AHI differed significantly based on gender, at any OSA severity level. There were no significant gender differences in sleepiness or quality of life. Treatment-related adverse reactions were more common among females.
Both females and males with OSA respond well to OA therapy, with nonsignificant gender differences in outcomes. Thus, the hypothesis that females respond better to OA treatment is rejected.
虽然使用口腔矫治器（OA）治疗阻塞性睡眠呼吸暂停（OSA）的总体成功率很高，但女性的成功率明显更高。为了验证已发表的数据，本研究的目的是在使用 OA 一年后评估参与者样本。主要结果是治疗反应，定义为随访时呼吸暂停低通气指数（AHI）<10 和/或与基线相比降低≥50%。次要措施来自标准化问卷。
纳入了 314 名主要患有中重度 OSA 的参与者，并指示他们每晚使用 OA。在基线和一年随访时，进行多导睡眠图记录和问卷调查，包括嗜睡（使用 Epworth 嗜睡量表测量）和生活质量（使用睡眠功能结果问卷测量）。
在 314 名参与者中，有 192 名完成了一年的评估：女性 51 名（27%），男性 141 名（73%）。总体而言，OA 治疗分别使女性和男性的应答者比例达到 78%和 77%。无论 OSA 严重程度如何，性别差异在改善程度或 AHI 的绝对变化方面均无显著差异。在嗜睡或生活质量方面，性别差异无统计学意义。与治疗相关的不良反应在女性中更为常见。
OSA 的女性和男性对 OA 治疗的反应均良好，结果无显著性别差异。因此，拒绝女性对 OA 治疗反应更好的假设。
