改良Activator矫治器治疗阻塞性睡眠呼吸暂停综合征

目的　对改良Activator矫治器治疗阻塞性睡眠呼吸暂停综合征的疗效进行观察。方法　用改良Acti vator矫治器治疗 10例已经确诊的OSAS ,治疗前后进行X线头影测量分析 ,并结合多导睡眠图监测来评价疗效。结果　戴用矫治器后下颌在水平向和垂直向的位移平均分别为 1.5 3mm和 8.6 3mm ,上气道间隙明显增加 ,呼吸暂停指数 (AI) ,低通气指数 (HI) ,呼吸紊乱指数 (AHI)明显降低 ,最低血氧饱和度 (SaO2 )明显升高。结论　改良Activator矫治器治疗阻塞性睡眠呼吸暂停综合征 ,疗效显著     

双(牙合)板矫治器治疗阻塞性睡眠呼吸暂停综合征的研究

目的介绍一种上下颌分体式的双(牙合)板矫治器,探讨应用该矫治器治疗阻塞性睡眠呼吸暂停综合征(OSAS)的效果.方法为 29 例 OSAS 患者制作双(牙合)板矫治器,戴用矫治器前后进行多导睡眠监测对比疗效;治疗前后进行标准化的问卷调查,记录患者症状的变化及口颌系统的不适感和副作用.结果与戴用矫治器前比较,26 例的呼吸暂停低通气指数下降了 50 % 以上,客观有效率为 89.7 %;呼吸暂停指数和低通气指数分别降低 74.39 % 和 47.94 %(P<0.01),夜间最低血氧饱和度明显升高(P<0.01).戴用矫治器初期不适症状主要为唾液增多及晨起后短暂的颞下颌关节和牙齿的酸胀感,一周内不适感基本消失.结论双(牙合)板矫治器是治疗轻、中度OSAS 的有效方法,其长期疗效和副作用尚待进一步观察.     

分体可调式止鼾器治疗OSAS的临床研究

目的：探讨分体可调式止鼾器治疗阻塞性睡眠呼吸暂停综合征（OSAS）的效果。方法：35例OSAS患者制作分体可调式矫治器，采用多导睡眠仪监测患者戴用前后呼吸紊乱指数（AHI），呼吸暂停指数（AI），低通气指数（HI）和SaO2指标变化，进行标准化问卷调查。结果：戴用矫治器前后对比，32例呼吸暂停低通气指数下降50％以上；呼吸暂停指数和低通气指数分别降低81．17％和49．45％（P〈0．01），夜间最低血氧饱和度明显升高（P〈0．01）．患者睡眠质量均有显著改善，鼾声均消失或明显减轻．结论：分体可调式止鼾器治疗轻、中度OSAS疗效明显。     

改良型Activator矫治器治疗OSAS疗效评价

目的 :通过戴用改良型Activator矫治器治疗OSAS ,探讨其影响患者睡眠呼吸结构 ,改善通气的作用机制。方法 :13例患者均根据多导睡眠呼吸监测结果及临床表现确诊为OSAS ,戴用改良的Activator矫治器 1-2月后再行多导睡眠呼吸监测 ,并与戴用前进行比较 ;结果 :戴用改良型Activator矫治器后 ,呼吸暂停低通气指数、呼吸紊乱指数、睡眠呼吸紊乱指数、最长呼吸暂停时间 (s)分别降低了 4.73± 3 .64、3 0 .85± 13 .3 2、3 0 .0 2± 9.48、5 5 .3 1± 2 2 .19(P <0 .0 1) ,最低血氧饱和度则升高了 13 .85± 6.2 4(P <0 .0 1) ,患者的客观症状如睡眠鼾声等得以改善。结论 :改良型Activator矫治器是下颌前移口腔矫治器治疗OSAS一种比较好的方法。     

Bionator矫治器治疗阻塞性睡眠呼吸暂停综合征

目的 对Bionator矫治器治疗阻塞性睡眠呼吸暂停综合征（OSAS) 疗效进行观察。方法 对8例确诊为OSAS的患者行Bionator保持咬He型矫治器治疗。作治疗前后X线头影测量分析,结合导睡眠图监测来评价疗效。结果 低通气指数（HI）、呼吸暂停指（AI）、呼吸紊乱指数（AHI）明显降低;而最低血氧饱和度(SaO2）则明显升高。头影测量表示下颌前移,上气道间隙明显扩大（P＜0．01）。结论 Bionator保持咬He矫治器可改善上气道通气状态,从而达到治疗OSAS的目的。     

两种口腔矫治器治疗老年OSAS的临床疗效评价

目的:探讨两种口腔矫治器治疗老年阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)的临床疗效。方法:选取40例老年OSAS患者,随机分为A、B两组,分别戴用silensor口腔矫治器和压膜式改良activator矫治器治疗。治疗6个月后,通过多导睡眠监测和上气道形态的CBCT测量,并结合患者主诉症状改善情况,评价两种口腔矫治器对老年OSAS患者的疗效。结果:戴用两种口腔矫治器后,老年OSAS患者的打鼾、憋醒和嗜睡症状得到改善;最低血氧饱和度升高,呼吸紊乱指数和呼吸暂停时间明显降低,差异具有统计学意义(P<0.05)。CBCT扫描显示腭咽和舌咽气道矢状径、面积和体积较治疗前明显增大,组间差异无统计学意义(P>0.05)。而silensor矫治器舒适度显著性优于改良activator式矫治器。结论:两种口腔矫治器对老年OSAS均有良好的临床疗效,silensor可调式矫治器的舒适性更好。     

分体式口腔矫治器治疗OSAHS患者前后上呼吸道形态CBCT分析

目的 观察阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者戴用分体式口腔矫治器前后呼吸功能及上呼吸道形态的变化,探讨口腔矫治器治疗OSAHS的机制.方法 对15例经多导睡眠仪监测确诊为轻、中度OSAHS患者,戴用口腔矫治器前及戴用矫治器3个月后的上呼吸道行CBCT扫描,运用MIMICS 10.01和AutoCAD2010对上气道各段的矢状径、横径、截面积以及容积等指标进行测量分析,并比较治疗前后OSAHS患者呼吸暂停指数（AI）、低通气指数（HI）、呼吸紊乱指数（AHI）和最低血氧饱和度（SaO2）等指标的变化.结果 戴用口腔矫治器治疗后,OSAHS患者上呼吸道腭咽和舌咽区域的矢状径、横径、横截面积和体积均明显增大（P＜0.05）,而鼻咽区域变化不明显.戴用口腔矫治器后呼吸暂停指数（AI）、低通气指数（HI）、呼吸紊乱指数（AHI）明显降低（P＜0.05）,最低血氧饱和度（SaO2）显著提高（P＜0.05）.结论 OSAHS患者戴用口腔矫治器后,可通过扩大上气道腭咽和舌咽区域,保持上气道气流通畅,改善患者的呼吸功能而达到治疗目的.     

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目的评价改良型软压膜式口腔矫治器治疗阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)的临床疗效。方法选择2008年1月至2010年7月在阜阳市人民医院体检中心口腔科经改良型软压膜式口腔矫治器治疗的OSAHS患者12例,观察戴用矫治器前、后的临床表现,并将其戴用矫治器前、后的多导睡眠仪(PSG)监测数据及X线头影测量结果进行分析。结果 OSAHS患者戴用改良型软压膜式口腔矫治器3个月至1年后,呼吸紊乱指数(AHI)、呼吸暂停指数(AI)、低通气指数(HI)均较戴用前明显降低,而血氧饱和度(SaO2)则有明显升高;X线头影测量显示治疗后的上气道宽度增加;达到改善患者生存质量的目的。结论改良型软压膜式口腔矫治器治疗OSAHS具有广阔的临床应用价值,尤其以无创伤性、可逆性、经济实用、戴用舒适感较强、便于携带而日益受到重视。     

阻鼾器治疗阻塞性睡眠呼吸暂停综合征的临床研究

目的　研究XT -1B型阻鼾器治疗阻塞性睡眠呼吸暂停综合征 (OSAS)的临床效果。方法　通过夜间PSG监测 ,观察和分析戴用阻鼾器前后睡眠呼吸紊乱指标的变化及主要症状的改变情况。结果　戴用阻鼾器后呼吸暂停低通气指数 (AHI)平均降低了 3 1.2次 /h(P <0 .0 0 1) ,最低血氧饱和度平均升高了 11.9% (P <0 .0 1) ,平均呼吸暂停时间 (MAT)减少了 12 .6s(P <0 .0 1) ,所有患者呼吸暂停现象明显改善 ,其中 11例呼吸暂停已完全消失。结论　阻鼾器治疗OSAS患者 ,可明显改善患者的睡眠质量、有效消除睡眠呼吸暂停 ,且可提高血氧饱和度 ,临床症状得到明显改善     

Silensor口腔矫治器治疗阻塞性睡眠呼吸暂停综合征后患者的上呼吸道变化

目的 通过三维CT观察Silensor口腔矫治器治疗阻塞性睡眠呼吸暂停综合征(OSAS)患者上呼吸道结构的变化,探讨Silensor口腔矫治器治疗OSAS的效果.方法 选择经多导夜间睡眠仪(PSG)监测确诊且符合Silensor口腔矫治器治疗的OSAS患者30例,分别在戴用Silensor口腔矫治器前和治疗4周后对患者...     

Effect of an oral appliance for obstructive sleep apnea syndrome

The purpose of this study was to evaluate the effect of an oral appliance (Sleep Splint) for obstructive sleep apnea syndrome (OSAS) patients, and to examine problems with this therapy. Fixed in the oral cavity, the Sleep Splint intends to reduce the occurrence of apnea and prevent blockage of the upper airway during sleep. In this study, the therapy using Sleep Splint was done for 50 patients (41 men and 9 women) who had been introduced by the physician diagnosing with OSAS. Sleep monitoring around an oral appliance mounting was carried out, and the effect was evaluated. In addition, the ESS was used in respect of the evaluation of the daytime sleepiness. However, four patients stopped using the oral appliance due to serious discomfort in the maxillofacial region, and they were excluded from the study. Forty-six patients were classified into three groups by the seriousness of OSAS, or into two groups according to body fatness, and the difference of the effect between each group was compared. The results obtained were as follows. 1. As to the Apnea hypopnea index (AHI), Apnea hypopnea density, Oxygen desaturation, and ESS, there was statistically significant improvement regardless of the seriousness of OSAS and body fatness. 2. About all patients except for the patient group of the mild cases (AHI < 10), the occurrence of snoring showed the statistically significant improvement. These results indicated that oral appliance therapy was an effective treatment for OSAS.     

A trial of titration in oral appliance therapy for obstructive sleep apnea syndrome

This study evaluated the effect of titration in oral appliance therapy for obstructive sleep apnea syndrome (OSAS), and examined problems with this test. However, the method of predicting the appropriate mandible position has not yet been established. In this study, titration was attempted in order to predict appropriate mandible position prior to wearing an oral appliance. Twenty-three male patients diagnosed as OSAS by a physician participated in this study. The mandible was protruded by a titratable splint (TS) until apneic and hypopneic signs had disappeared. Moreover, polisomnography (PSG) was used to monitor brain wave patterns, eye movement, muscle tone, body movement and breathing. Sleep study was performed by a portable sleep monitoring device before and after examination wearing titrated oral appliance (OA), and the effect of therapy was evaluated. The results obtained were as follows. 1. In the Apnea Hypopnea Index (AHI), Apnea Hypopnea density (AH density), lowest SpO2, Oxygen Desaturation Index (ODI), there was a statistically significant improvement. The mean AHI reduced from 13.8 to 4.7 (p<0.001). The mean AH density reduced from 12.0 to 3.5 (p<0.001). The mean lowest SpO2 increased from 78.7 to 84.7 (p<0.0001). The mean ODI reduced from 15.7 to 6.1 (p<0.001). 2.. The average proportion of protrusive distance for movable distance was 71.7%. 3. Only one patient complained of discomfort in the maxillofacial region, however, this discomfort disappeared after adjustment of OA. Therefore, it is suggested that titration for OA is a very useful examination for OSAS therapy.     

Effects of a Mandibular Advancement Device for the Treatment of Sleep Apnea Syndrome and Snoring on Respiratory Function and Sleep Quality

In this study the fabrication of a simplified mandibular advancement device for sleep apnea syndrome was described. Its effect on respiratory function and sleep quality variables was evaluated polysomnographically in 256 patients with sleep apnea syndrome and snoring. Polysomnographic recordings were performed twice, before and after insertion of the oral appliance. The mean apnea-hypopnea index (AHI) decreased significantly (p<0.0001) with the appliance to 18.2 from 43.2 without it. Responders defined by AHI <10 were 54% and those defined as a 50% decrease of AHI were 66%. Oxygen saturation, duration of apnea, sleep efficiency, and total arousal were improved significantly after treatment without major side effects. The device improved significantly the respiratory function and sleep quality in patients with sleep apnea syndrome. Compliance was about 90% followed for 2.5 years. This appliance offers some advantages over other therapies because it is noninvasive, easy to fabricate, and well accepted by patients.     

Effects of a mandibular advancement device for the treatment of sleep apnea syndrome and snoring on respiratory function and sleep quality

In this study the fabrication of a simplified mandibular advancement device for sleep apnea syndrome was described. Its effect on respiratory function and sleep quality variables was evaluated polysomnographically in 256 patients with sleep apnea syndrome and snoring. Polysomnographic recordings were performed twice, before and after insertion of the oral appliance. The mean apneahypopnea index (AHI) decreased significantly (p < 0.0001) with the appliance to 18.2 from 43.2 without it. Responders defined by AHI < 10 were 54% and those defined as a 50% decrease of AHI were 66%. Oxygen saturation, duration of apnea, sleep efficiency, and total arousal were improved significantly after treatment without major side effects. The device improved significantly the respiratory function and sleep quality in patients with sleep apnea syndrome. Compliance was about 90% followed for 2.5 years. This appliance offers some advantages over other therapies because it is noninvasive, easy to fabricate, and well accepted by patients.     

Obstructive sleep apnea patients with the oral appliance experience pharyngeal size and shape changes in three dimensions

Pharyngeal size and shape differences between pre- and posttrials of a mandible-protruding oral appliance were investigated using cine computerized tomography (CT). Fourteen patients diagnosed with obstructive sleep apnea whose apnea-hypopnea index was higher than 5 and arousal index higher than 20 underwent a second overnight sleep study to evaluate the effectiveness of the oral appliance. Three-dimensional changes in pharyngeal shape measured on cross-sectional CT images during two respiratory cycles after oral appliance delivery were estimated by three variables: (1) lateral dimension, (2) anterior-posterior dimension, and (3) cross-sectional area at five vertical levels. Apnea indices improved significantly when the appliance was used. During apnea, measurements at retropalatal and retroglossal levels decreased most. However, the cross-sectional area of these levels appeared to increase significantly (P < .05) with the appliance in place during wakefulness. The oral appliance appears to enlarge the pharynx to a greater degree in the lateral than in the sagittal plane at the retropalatal and retroglossal levels of the pharynx, suggesting a mechanism for the effectiveness of oral appliances that protrude the mandible.