Evaluation of Respiratory Resistance as a Predictor for Oral Appliance Treatment Response in Obstructive Sleep Apnea: A Pilot Study.
Evaluation of Respiratory Resistance as a Predictor for Oral Appliance Treatment Response in Obstructive Sleep Apnea: A Pilot Study.
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DOI：
10.3390/jcm10061255
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发表时间：
2021-03-18
影响因子：
3.9
通讯作者：
Miyazaki Y
中科院分区：
文献类型：
--
作者：
Ishiyama H;Hideshima M;Inukai S;Tamaoka M;Nishiyama A;Miyazaki Y
本研究的目的是确定呼吸阻力作为阻塞性睡眠呼吸暂停 (OSA) 口腔矫治器 (OA) 反应预测因子的效用。招募了 27 名 OSA 患者（平均呼吸事件指数 (REI)：17.5 ± 6.5 次事件/小时）。在基线时，通过脉冲振荡法（IOS）在仰卧位佩戴鼻罩测量呼吸阻力（R20），并获得头影测量X光片来分析咽部气道间隙（SPAS：上后气道间隙，MAS：中气道间隙，IAS：下气道间隙）。评估 OA 治疗后的 R20 和 X 光片，并分析相对于基线的变化。使用便携式设备进行 OA 睡眠测试。根据治疗后 REI 较基线改善≥ 50%，或 REI < 5 将受试者分为有反应者和无反应者，并比较两组之间的 R20 降低率。受试者包括 20 名有反应者和 7 名无反应者。有反应者中 OA 的 R20 降低率显着高于无反应者（14.4 ± 7.9 % 与 2.4 ± 9.8 %，p < 0.05）。在应答者中，OA 导致 SPAS、MAS 和 IAS 显着扩大，R20 显着降低 (p < 0.05)。无反应者之间没有显着差异（p > 0.05）。 Logistic 多元回归分析显示，R20 降低率可预测 OA 治疗反应（2% 增量比值比 (OR)，24.5；95% CI，21.5–28.0；p = 0.018）。这项初步研究证实，呼吸阻力在预测 OA 治疗反应方面可能具有重要的临床实用性。
The aim of this study was to determine the utility of respiratory resistance as a predictor of oral appliance (OA) response in obstructive sleep apnea (OSA). Twenty-seven patients with OSA (mean respiratory event index (REI): 17.5 ± 6.5 events/h) were recruited. At baseline, the respiratory resistance (R20) was measured by impulse oscillometry (IOS) with a fitted nasal mask in the supine position, and cephalometric radiographs were obtained to analyze the pharyngeal airway space (SPAS: superior posterior airway space, MAS: middle airway space, IAS: inferior airway space). The R20 and radiographs after the OA treatment were evaluated, and the changes from the baseline were analyzed. A sleep test with OA was carried out using a portable device. The subjects were divided into Responders and Non-responders based on an REI improvement ≥ 50% from the baseline, or REI < 5 after treatment, and the R20 reduction rate between the two groups were compared. The subjects comprised 20 responders and 7 non-responders. The R20 reduction rate with OA in responders was significantly greater than it was in non-responders (14.4 ± 7.9 % versus 2.4 ± 9.8 %, p < 0.05). In responders, SPAS, MAS, and IAS were significantly widened and R20 was significantly decreased with OA (p < 0.05). There was no significant difference in non-responders (p > 0.05). A logistic multiple regression analysis showed that the R20 reduction rate was predictive for OA treatment responses (2% incremental odds ratio (OR), 24.5; 95% CI, 21.5–28.0; p = 0.018). This pilot study confirmed that respiratory resistance may have significant clinical utility in predicting OA treatment responses.
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DOI：
10.1007/s11325-019-01966-5
发表时间：
2020-12
期刊：
Sleep & breathing = Schlaf & Atmung
影响因子：
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作者：
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