Oral Appliance Treatment for Obstructive Sleep Apnea: A Retrospective Study

口腔內矯正器對於阻塞性睡眠呼吸中止症後群之療效：回溯性研究

邱翊洲(Yi-Chou Chiou) ； 陳萬宜(Man-Yee Chen) ； 張開明(Kai-Ming Chang) ； 黃偉彰(Wei-Chang Huang) ； 許正園(Jeng-Yuan Hsu)

《胸腔醫學》 24卷6期 (2009/12) Pp. 307-314

https://doi.org/10.29806/TM.200912.0001

摘要

Obstructive sleep apnea (OSA) is prevalent among middle-aged adults; it has been proven to be related to cardiovascular events and could possibly cause traffic accidents. Although continuous positive airway pressure applied to the upper airway via a nasal mask (nasal CPAP) could effectively eliminate the obstruction during sleep, its cumbersome nature and high cost have prompted clinicians to seek alternative treatments. Oral appliances have become an effective method in the treatment of OSA. In this study, we retrospectively investigated the effects of oral appliance (Bionator) treatment on 74 patients with sleep-related problems. Medical charts were reviewed and the data of the patients' disease characteristics and treatment responses were extracted and analyzed. The objective parameters, sleep efficiency and respiratory disturbance index (RDI), were significantly improved after the use of the oral appliance (80.8±13.8 vs. 87.8±7.8, p=0.002 and 29.9±21.6 vs. 17.4±19.1, p＜0.001, respectively). Oral appliance treatment also altered the distribution of disease severities toward a simple snoring and mild OSA predominance. The majority of patients had moderate to good responses in all 3 severity groups. No particular predictive factor could be found for treatment response. The subjective parameters of snoring and excessive daytime sleepiness were also improved by oral appliance therapy: Snoring Outcomes Survey score (SOS): 29.2±5.5 vs. 20.3±7.0, p＜0.001; Spouse and Bed Partner Survey score (SBPS): 12.2±2.6 vs. 6.8±3.6, p＜0.001; Epworth Sleepiness Scale (ESS): 9.2±5.0 vs. 5.9±4.2, p=0.004). There was no serious adverse effect. The most common adverse effects reported were temporo-mandibular joint discomfort (55.4%), followed by sleep disturbance (29.7%) and pain (17.6%). Conclusion: Oral appliances are effective for OSA of all severities with few complications. Oral appliances could be an inexpensive and convenient alternative for nasal CPAP in OSA treatment.

關鍵字

阻塞型睡眠呼吸中止症候群 ； 口腔內矯正器

並列摘要

Obstructive sleep apnea (OSA) is prevalent among middle-aged adults; it has been proven to be related to cardiovascular events and could possibly cause traffic accidents. Although continuous positive airway pressure applied to the upper airway via a nasal mask (nasal CPAP) could effectively eliminate the obstruction during sleep, its cumbersome nature and high cost have prompted clinicians to seek alternative treatments. Oral appliances have become an effective method in the treatment of OSA. In this study, we retrospectively investigated the effects of oral appliance (Bionator) treatment on 74 patients with sleep-related problems. Medical charts were reviewed and the data of the patients' disease characteristics and treatment responses were extracted and analyzed. The objective parameters, sleep efficiency and respiratory disturbance index (RDI), were significantly improved after the use of the oral appliance (80.8±13.8 vs. 87.8±7.8, p=0.002 and 29.9±21.6 vs. 17.4±19.1, p＜0.001, respectively). Oral appliance treatment also altered the distribution of disease severities toward a simple snoring and mild OSA predominance. The majority of patients had moderate to good responses in all 3 severity groups. No particular predictive factor could be found for treatment response. The subjective parameters of snoring and excessive daytime sleepiness were also improved by oral appliance therapy: Snoring Outcomes Survey score (SOS): 29.2±5.5 vs. 20.3±7.0, p＜0.001; Spouse and Bed Partner Survey score (SBPS): 12.2±2.6 vs. 6.8±3.6, p＜0.001; Epworth Sleepiness Scale (ESS): 9.2±5.0 vs. 5.9±4.2, p=0.004). There was no serious adverse effect. The most common adverse effects reported were temporo-mandibular joint discomfort (55.4%), followed by sleep disturbance (29.7%) and pain (17.6%). Conclusion: Oral appliances are effective for OSA of all severities with few complications. Oral appliances could be an inexpensive and convenient alternative for nasal CPAP in OSA treatment.

並列關鍵字

obstructive sleep apnea ； oral appliance ； oral device ； Bionator