Sleep Apnea Identification & Treatment in Dentistry

描述(申请人提供)：阻塞性睡眠呼吸暂停(OSA)是在睡眠医学实践中观察到的最常见的疾病，与任何其他睡眠障碍相比，它导致更多的死亡率和发病率。OSA会导致白天嗜睡和认知障碍，并与高血压和心血管疾病、糖尿病和中风风险增加有关。未经治疗的阻塞性睡眠呼吸暂停综合征患者发生工业和机动车事故的可能性要高出3-7倍。 最近基于人群的流行病学研究表明，阻塞性睡眠呼吸暂停综合征在成年人中高度流行。每五个成年人中就有一个被确认为轻度阻塞性睡眠呼吸暂停；每十五个成年人中就有一个患有中度到重度阻塞性睡眠呼吸暂停。这些研究报告说，即使是轻微的OSA也与显著的发病率有关。尽管越来越多的证据表明，未经治疗的阻塞性睡眠呼吸暂停综合症威胁到公众健康、安全和生产力，但目前的估计显示，超过85%的中度至重度阻塞性睡眠呼吸暂停综合症患者仍未得到诊断，这主要是由于医疗保健专业人员和公众缺乏认识所致。这项拟议研究的目标之一是通过与牙医和牙科睡眠专家的合作来提高对未诊断的OSA的认识，因为他们越来越多地参与到使用口腔矫治器或下颌推进装置(MAD)识别和治疗OSA的工作中。 高级大脑监测公司开发并验证了呼吸暂停风险评估系统(ARES)，这是一种易于管理的OSA家庭诊断测试，为耗时、昂贵的实验室睡眠研究提供了一种替代方案。Ares为牙科睡眠专家评估OSA患者提供了一种经济高效的方法。也可以在插入口腔矫治器后重复应用ARES，以提供调整装置的指导并记录治疗效果。第一阶段研究旨在证明ARES在口腔矫治器治疗前后对30名患者进行评估的有效性。还将进行初步调查，以确定口腔矫治器治疗成功的预测因素，以便选择最有可能从中受益的患者。

DESCRIPTION (provided by applicant): Obstructive Sleep Apnea (OSA) is the most common disorder observed in the practice of sleep medicine and is responsible for more mortality and morbidity than any other sleep disorder. OSA causes daytime drowsiness and cognitive impairment, and has been associated with hypertension and increased risk of cardiovascular disease, diabetes and stroke. Untreated OSA patients are 3-7 times more likely to be involved in industrial and motor vehicle accidents. Recent population-based epidemiological studies reveal OSA is highly prevalent in adults. One in five adults was identified with mild OSA; one in fifteen have moderate to severe OSA. These studies reported that even mild OSA is associated with significant morbidity. Despite the growing evidence that untreated OSA threatens public health, safety and productivity, current estimates reveal that more than 85% of individuals with moderate to severe OSA remain undiagnosed largely as a result of lack of awareness among healthcare professionals and the public. One goal of the proposed research is to increase awareness of undiagnosed OSA through collaboration with dentists and dental sleep specialists because they are increasingly involved with the identification and treatment of OSA with oral appliances or Mandibular Advancement Devices (MAD). Advanced Brain Monitoring, Inc. developed and validated the Apnea Risk Evaluation System (ARES), an easy to administer, in-home diagnostic test for OSA to provide an alternative to time-consuming, expensive laboratory sleep studies. ARES provides a cost-effective method for dental sleep specialists to evaluate patients for OSA. ARES can also be applied repeatedly following the insertion of the oral appliances to provide guidance in adjusting the devices and to document treatment efficacy. The Phase I study is designed to demonstrate the utility of ARES in evaluating 30 patients prior to and following treatment with oral appliance therapy. A preliminary investigation will also be conducted to identify predictors of treatment success with oral appliances to allow selection of patients most likely to benefit from it.