止鼾器於睡眠呼吸中止症候群病患之治療－文獻回顧

Oral Appliance Treatment in Obstructive Sleep Apnea Syndrome-Literature Review

劉怡敏(Yi-Min Liu) ； 李佩玲(Pei-Lin Lee) ； 陳韻之(Yunn-Jy Chen) ； 姚宗珍(Chung-Chen Jane Yao)

《中華民國齒顎矯正學雜誌》 20卷4期 (2008/12) Pp. 31-38

https://doi.org/10.30036/TJO.200812.0004

摘要

睡眠呼吸中止症(Obstructive sleep apnea syndrome)是一種常見的睡眠障礙病症，其診斷主要仰賴病人臨床症狀與多型態睡眠生理報告。在其多種治療方式中，止鼾器為一簡單有效且接受度高的方式。由本文獻回顧，清楚顯示止鼾器能改善病人睡眠時打鼾的情形、睡眠評估的指數、血壓、神經心理認知狀態與生活品質。此外，長期觀察佩帶止鼾器副作用的文獻曾指出病人配戴的時間愈長，對垂直覆蓋的減少、下顎平面角增加、及齒列的變化愈是顯著。而亦有研究指出成功治療之病患具有某些參考指標的顱顏型態特徵，包括：軟顎長度較短、後顎部呼吸道較寬、舌骨至下顎平面之距離較短、S-鼻根點(nasion)-棘下點(subspinale)交角較大等等。此文獻回顧為止鼾器的治療帶來更完整的認識。雖然其不似連續性正壓輔助器有效，但其舒適度與病患配合度高，實為另一種有效且方便的治療選擇。

關鍵字

睡眠呼吸中止症 ； 止鼾器 ； 副作用

並列摘要

Obstructive sleep apnea (OSA) syndrome is a common sleeping disorder problem. The diagnosis depends on features of patient's clinical symptoms and polysomnographic examination. Among several treatment modalities in OSA patients, oral appliance is a simple, effective and popular treatment option. Oral appliances have been clearly shown to improve many clinical signs, including patient's sleep quality, indexes of polysomnography, blood pressure, neurophycosocial cognition and life quality. Besides, longitudinal studies of the long-term adverse effect of oral appliance revealed that the longer the patient wore oral appliances, the more significant the effects were, which included overbite reduction, increase in mandibular plane angle and the change of dentition. Moreover, some specific craniofacial features in successful responders of oral appliances have been reported, which included a shorter soft palate, wider postpalatal airway dimension, reduced distance from hyoid bone to mandibular plane and larger S-N-Subspinale angle. Despite for that oral appliance is not efficacious as CPAP, the adherence and preference of oral appliance makes it an effective treatment alternative and may provide a better quality of life.

並列關鍵字

obstructive sleep apnea ； oral appliance ； adverse effect