{"title":"使用口腔矫治器的阻塞性睡眠呼吸暂停患者的残余过度嗜睡与多导睡眠图参数之间的关系","authors":"","doi":"10.1016/j.ajoms.2024.02.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>Oral appliances (OA) are effective in reducing apnea-hypopnea index (AHI) in patients with obstructive sleep apnea (OSA). However, residual excessive sleepiness (RES) may occur despite successful OA treatment, and there is limited evidence on the cause of this. Furthermore, few studies have examined the association between changes in sleepiness after OA treatment and polysomnography (PSG) parameters. The purpose of this study was to evaluate the prevalence of RES after OA treatment and examine the effects of changes in sleepiness on PSG parameters.</p></div><div><h3>Methods</h3><p>The study sample included 121 participants who were diagnosed with OSA and had evaluated RES after OA treatment outcomes using PSG. All patients were scored using the Epworth sleepiness scale (ESS) at baseline and after OA treatment, and the association between changes in ESS and PSG parameters were examined statistically.</p></div><div><h3>Results</h3><p>Approximately 20.5% of OA responders (n = 73) exhibited RES. The ESS change better group (n = 24, ESS decreased by ≥2 points after treatment) exhibited significantly lower baseline lowest SpO<sub>2</sub> values (82.0 ± 7.9 vs. 87.5 ± 4.2; p-value <0.01) and higher baseline CT90 value (2.4 ± 4.0 vs. 0.5 ± 0.9; p-value <.05) compared to the ESS change worse group (n = 19, ESS increased by ≥2 points after treatment). Moreover, the CT90 change rate after OA treatment was also significantly higher in the former group.</p></div><div><h3>Conclusion</h3><p>OSA patients can exhibit RES despite improvements in AHI after OA treatment. Furthermore, improvements in ESS can potentially help predict hypoxia parameters in PSG.</p></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"36 5","pages":"Pages 729-734"},"PeriodicalIF":0.4000,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212555824000139/pdfft?md5=af3135f8b9f5bd5b4d866a079e54406f&pid=1-s2.0-S2212555824000139-main.pdf","citationCount":"0","resultStr":"{\"title\":\"The association between residual excessive sleepiness and polysomnography parameters in patients with obstructive sleep apnea using oral appliances\",\"authors\":\"\",\"doi\":\"10.1016/j.ajoms.2024.02.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>Oral appliances (OA) are effective in reducing apnea-hypopnea index (AHI) in patients with obstructive sleep apnea (OSA). However, residual excessive sleepiness (RES) may occur despite successful OA treatment, and there is limited evidence on the cause of this. Furthermore, few studies have examined the association between changes in sleepiness after OA treatment and polysomnography (PSG) parameters. The purpose of this study was to evaluate the prevalence of RES after OA treatment and examine the effects of changes in sleepiness on PSG parameters.</p></div><div><h3>Methods</h3><p>The study sample included 121 participants who were diagnosed with OSA and had evaluated RES after OA treatment outcomes using PSG. All patients were scored using the Epworth sleepiness scale (ESS) at baseline and after OA treatment, and the association between changes in ESS and PSG parameters were examined statistically.</p></div><div><h3>Results</h3><p>Approximately 20.5% of OA responders (n = 73) exhibited RES. The ESS change better group (n = 24, ESS decreased by ≥2 points after treatment) exhibited significantly lower baseline lowest SpO<sub>2</sub> values (82.0 ± 7.9 vs. 87.5 ± 4.2; p-value <0.01) and higher baseline CT90 value (2.4 ± 4.0 vs. 0.5 ± 0.9; p-value <.05) compared to the ESS change worse group (n = 19, ESS increased by ≥2 points after treatment). Moreover, the CT90 change rate after OA treatment was also significantly higher in the former group.</p></div><div><h3>Conclusion</h3><p>OSA patients can exhibit RES despite improvements in AHI after OA treatment. Furthermore, improvements in ESS can potentially help predict hypoxia parameters in PSG.</p></div>\",\"PeriodicalId\":45034,\"journal\":{\"name\":\"Journal of Oral and Maxillofacial Surgery Medicine and Pathology\",\"volume\":\"36 5\",\"pages\":\"Pages 729-734\"},\"PeriodicalIF\":0.4000,\"publicationDate\":\"2024-02-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2212555824000139/pdfft?md5=af3135f8b9f5bd5b4d866a079e54406f&pid=1-s2.0-S2212555824000139-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Oral and Maxillofacial Surgery Medicine and Pathology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2212555824000139\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2212555824000139","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
目标口腔矫治器(OA)可有效降低阻塞性睡眠呼吸暂停(OSA)患者的呼吸暂停-低通气指数(AHI)。然而,尽管 OA 治疗效果显著,但仍可能出现残余过度嗜睡(RES)的情况,而关于其原因的证据却很有限。此外,很少有研究探讨 OA 治疗后嗜睡的变化与多导睡眠图(PSG)参数之间的关联。本研究的目的是评估 OA 治疗后 RES 的发生率,并研究嗜睡变化对 PSG 参数的影响。所有患者在基线和 OA 治疗后都使用埃普沃思嗜睡量表(ESS)进行了评分,并对ESS 变化与 PSG 参数之间的关联进行了统计学研究。结果约 20.5% 的 OA 反应者(n = 73)表现出 RES。ESS变化较好组(n = 24,治疗后ESS下降≥2分)与ESS变化较差组(n = 19,治疗后ESS上升≥2分)相比,基线最低SpO2值明显降低(82.0 ± 7.9 vs. 87.5 ± 4.2;p值<0.01),基线CT90值明显升高(2.4 ± 4.0 vs. 0.5 ± 0.9;p值<.05)。此外,前者治疗后的 CT90 变化率也明显高于后者。此外,ESS 的改善可能有助于预测 PSG 中的缺氧参数。
The association between residual excessive sleepiness and polysomnography parameters in patients with obstructive sleep apnea using oral appliances
Objective
Oral appliances (OA) are effective in reducing apnea-hypopnea index (AHI) in patients with obstructive sleep apnea (OSA). However, residual excessive sleepiness (RES) may occur despite successful OA treatment, and there is limited evidence on the cause of this. Furthermore, few studies have examined the association between changes in sleepiness after OA treatment and polysomnography (PSG) parameters. The purpose of this study was to evaluate the prevalence of RES after OA treatment and examine the effects of changes in sleepiness on PSG parameters.
Methods
The study sample included 121 participants who were diagnosed with OSA and had evaluated RES after OA treatment outcomes using PSG. All patients were scored using the Epworth sleepiness scale (ESS) at baseline and after OA treatment, and the association between changes in ESS and PSG parameters were examined statistically.
Results
Approximately 20.5% of OA responders (n = 73) exhibited RES. The ESS change better group (n = 24, ESS decreased by ≥2 points after treatment) exhibited significantly lower baseline lowest SpO2 values (82.0 ± 7.9 vs. 87.5 ± 4.2; p-value <0.01) and higher baseline CT90 value (2.4 ± 4.0 vs. 0.5 ± 0.9; p-value <.05) compared to the ESS change worse group (n = 19, ESS increased by ≥2 points after treatment). Moreover, the CT90 change rate after OA treatment was also significantly higher in the former group.
Conclusion
OSA patients can exhibit RES despite improvements in AHI after OA treatment. Furthermore, improvements in ESS can potentially help predict hypoxia parameters in PSG.