Treatment success with a mandibular advancement device is related to supine-dependent sleep apnea
Treatment success with a mandibular advancement device is related to supine-dependent sleep apnea
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DOI：
10.1378/chest.114.6.1630
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发表时间：
1998-12-01
期刊：
影响因子：
9.6
通讯作者：
Franklin, KA
中科院分区：
文献类型：
--
作者：
Marklund, M;Persson, M;Franklin, KA
研究目的：评价下颌推进装置对仰卧依赖性睡眠呼吸暂停患者和非仰卧依赖性睡眠呼吸暂停患者的效果。设计：前瞻性研究。单位：瑞典于默奥大学医院呼吸内科。患者：阻塞性睡眠呼吸暂停患者26例。干预：单独制造和调整下颌推进装置。测量方法：使用和不使用该设备记录夜间多导睡眠记录。当仰卧位呼吸暂停-低通气指数大于等于10，且侧卧位呼吸暂停-低通气指数< 10时为仰卧依赖型睡眠呼吸暂停，侧卧位呼吸暂停-低通气指数大于等于10时为非仰卧依赖型睡眠呼吸暂停。12 supine-dependent睡眠呼吸暂停患者,设备减少了仰卧位低通气指数的平均41(范围,16 - 70)到5.9(范围0.0 - 15)(p < 0.01),在14个non-supine-dependent睡眠呼吸暂停的患者,治疗减少了仰卧位低通气指数从44(范围1.8 - 73)到21岁(范围6.3 - 60)(p < 0.05)和外侧低通气指数从21岁(范围,12 - 70)到4.5 (31),0.0 (p < 0.01),对于年龄、肥胖、下颌前移和下颌开口等因素调整后的仰卧位睡眠呼吸暂停，仰卧位和侧卧位呼吸暂停降低与呼吸暂停低通气指数< 10的比值比为30 （p < 0.01）。结论：下颌前移装置成功降低呼吸暂停与仰卧位睡眠呼吸暂停高度相关。
Study objective: To evaluate the effect of a mandibular advancement device in patients with supine-dependent sleep apnea and patients with non-supine-dependent sleep apnea,Design: Prospective study.Setting: Department of Respiratory Medicine, University Hospital, Umea, Sweden.Patients: Twenty-six patients with obstructive sleep apnea.Intervention: Individually fabricated and adjusted mandibular advancement devices.Measurements: Over night polysomnographic sleep recordings with and without the device. Supine-dependent sleep apnea was defined when the supine apnea-hypopnea index was greater than or equal to 10, together with a lateral apnea-hypopnea index of < 10, Non-supine-dependent sleep apnea was considered when the lateral apnea-hypopnea index was greater than or equal to 10,Results: In 12 patients with supine-dependent sleep apnea, the device reduced the supine apnea-hypopnea index from a median of 41 (range, 16 to 70) to 5.9 (range, 0.0 to 15) (p < 0.01), In 14 patients with non-supine-dependent sleep apnea, the treatment reduced the supine apnea-hypopnea index from 44 (range, 1.8 to 73) to 21 (range, 6.3 to 60) (p < 0.05) and the lateral apnea-hypopnea index from 21 (range, 12 to 70) to 4.5 (range, 0.0 to 31) (p < 0.01), The odds ratio for a successful apnea reduction to an apnea-hypopnea index of < 10 in both the supine and the lateral positions was 30 for supine-dependent sleep apnea adjusted for age, obesity, mandibular advancement, and mandibular opening (p < 0.01),Conclusion: Successful apnea reduction with a mandibular advancement device is highly related to supine-dependent sleep apnea.