Update on oral appliance therapy.
Update on oral appliance therapy.
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DOI：
10.1183/16000617.0083-2019
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发表时间：
2019-09-30
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口腔矫治器越来越多地被推荐用于阻塞性睡眠呼吸暂停（OSA）患者和那些不耐受或不喜欢持续气道正压通气的患者。最常用的口腔矫治器在睡眠期间推进下颌，即所谓的下颌前移装置（MAD）。患者寻求治疗是因为打鼾、日间症状、呼吸暂停干扰睡眠以及心血管风险方面的长期后果。MAD可降低呼吸暂停-低通气指数，但在患者中程度不同。主要在更严重的OSA患者中观察到对日间嗜睡的影响。MAD治疗的OSA患者的血压可能会降低。然而，在呼吸暂停减少、嗜睡和其他症状减少以及未来健康受损风险降低方面，哪些患者将对这种治疗作出反应还不确定。副作用的发生目前也难以预测。大多数睡眠呼吸暂停患者患有心血管疾病、2型糖尿病和抑郁症等各种合并症。最新的研究结果表明，考虑到这种多方面疾病的各个方面，患者的表型分析将为夜间睡眠呼吸障碍患者的MAD适应症提供更多信息。这篇综述总结了有关MAD治疗的最新知识。口腔矫治器越来越多地用于阻塞性睡眠呼吸暂停患者的治疗。本次更新强调了关于这种疗法的最新知识。http://bit.ly/2Za1IGl
Oral appliances are increasingly recommended for selected patients with obstructive sleep apnoea (OSA) and those who do not tolerate nor prefer continuous positive airway pressure. The most commonly used oral appliance advances the lower jaw during sleep, the so-called mandibular advancement device (MAD). Patients seek treatment because of disturbing snoring, daytime symptoms, apnoeas that disturb sleep and the longer term consequences with regard to cardiovascular risks. MADs reduce the apnoea–hypopnoea index, although to various degrees among patients. Effects on daytime sleepiness have been observed mainly among the more severe OSA patients. Blood pressure may be reduced in MAD-treated OSA patients. There is, however, uncertainty about which patients will respond to this therapy in terms of apnoea reductions, decreased sleepiness and other symptoms, and reduced risk for future impaired health. The occurrence of side-effects also remains difficult to predict at present. The majority of sleep apnoea patients suffer from various comorbidities in terms of cardiovascular diseases, type 2 diabetes and depression. The most recent findings indicate that phenotyping of patients, considering various aspects of this multifaceted disease, will shed more light on the indications for MADs in patients with nightly sleep breathing disturbances. This review summarises the most recent knowledge about MAD treatment. Oral appliances are increasingly used in the treatment of patients with obstructive sleep apnoea. This update highlights the most recent knowledge about this therapy. http://bit.ly/2Za1IGl
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DOI：
10.1164/rccm.200311-1571oc
发表时间：
2004-09-15
影响因子：
24.7
作者：
Barnes, M;McEvoy, RD;Pierce, RJ
通讯作者：
Pierce, RJ
影响因子：
2.5
作者：
Andren, Ann;Hedberg, Par;Tegelberg, Ake
通讯作者：
Tegelberg, Ake
影响因子：
4.8
作者：
Anitua, Eduardo;Duran-Cantolla, Joaquin;Hamdan Alkhraisat, Mohammad
通讯作者：
Hamdan Alkhraisat, Mohammad
影响因子：
2.6
作者：
Fransson, Anette M. C.;Kowalczyk, Agata;Isacsson, Goran
通讯作者：
Isacsson, Goran
影响因子：
5.1
作者：
Bultmann, U;de Vries, M;Kant, I
通讯作者：
Kant, I