Yoffe N, Clark G T, Blumenfeld I, Peled R, Peled E, Lavie P
Sleep Laboratory, Technion Faculty of Medicine, Haifa.
Harefuah. 1995 May 1;128(9):533-6, 600.
The efficacy of the anterior mandibular positioning (AMP) device in obstructive sleep apnea syndrome was assessed. This device advances the mandible anteriorly by approximately 5-7 mm. 29 patients were examined and questioned about temporomandibular (TM) and facial pain before and after treatment with the device. Polysomnographic sleep studies were performed on all before, and 2 weeks after continuous use of the AMP device. 10 of the patients also underwent polysomnographic follow-up after 1 year. The mean apnea index (AI) before treatment was 40.1, which decreased to 24.3 (p < 0.0001) after 14.3 days of treatment with the AMP device. O2 saturation also increased, from 84.2% before, to 89.2% after treatment (p < 0.002). In 10 patients the mean AI after 1 year was 24.9, not different from that after only 2 weeks of treatment, but significantly different from their mean AI before treatment (39.8). Use of the AMP device did not change blood saturation levels; neither did it affect dental status, action of the masticatory muscles, nor did it cause TM joint dysfunction. 21 patients (72.4%) have now been fitted with an AMP device, and the mean follow-up is 13.4 months (range 2-22); 3 have been using the AMP only intermittently for TM joint pain or discomfort. We conclude that the AMP device helps the majority of patients and is an alternative, nonsurgical method for treating obstructive sleep apnea syndrome.
评估了下颌前伸定位（AMP）装置在阻塞性睡眠呼吸暂停综合征中的疗效。该装置可使下颌向前推进约5-7毫米。对29例患者在使用该装置治疗前后进行了颞下颌关节（TM）和面部疼痛的检查及询问。所有患者在连续使用AMP装置前及使用2周后均进行了多导睡眠图睡眠研究。其中10例患者在1年后还进行了多导睡眠图随访。治疗前平均呼吸暂停指数（AI）为40.1，使用AMP装置治疗14.3天后降至24.3（p<0.0001）。血氧饱和度也从之前的84.2%升至治疗后的89.2%（p<0.002）。10例患者1年后的平均AI为24.9，与仅治疗2周后的结果无差异，但与治疗前的平均AI（39.8）有显著差异。使用AMP装置未改变血氧饱和度水平；也未影响牙齿状况、咀嚼肌功能，也未导致TM关节功能障碍。21例患者（72.4%）现已佩戴AMP装置，平均随访时间为13.4个月（范围2-22个月）；3例因TM关节疼痛或不适仅间歇性使用AMP装置。我们得出结论，AMP装置对大多数患者有帮助，是治疗阻塞性睡眠呼吸暂停综合征的一种非手术替代方法。
