A promising concept of combination therapy for positional obstructive sleep apnea

被引:92
作者
Dieltjens, Marijke [1 ,2 ,3 ,7 ]
Vroegop, Anneclaire V. [2 ,3 ,7 ]
Verbruggen, Annelies E. [2 ,3 ,7 ]
Wouters, Kristien [4 ]
Willemen, Marc [5 ]
De Backer, Wilfried A. [5 ,6 ,7 ]
Verbraecken, Johan A. [5 ,6 ,7 ]
Van de Heyning, Paul H. [2 ,3 ,5 ,7 ]
Braem, Marc J. [1 ,7 ]
de Vries, Nico [2 ,3 ,7 ,8 ]
Vanderveken, Olivier M. [2 ,3 ,5 ,7 ]
机构
[1] Antwerp Univ Hosp UZA, Dept Special Care Dent, B-2650 Edegem, Belgium
[2] Antwerp Univ Hosp UZA, ENT Dept, Edegem, Belgium
[3] Antwerp Univ Hosp UZA, Head & Neck Surg, Edegem, Belgium
[4] Antwerp Univ Hosp UZA, Sci Coordinat & Biostat, B-2650 Edegem, Belgium
[5] Antwerp Univ Hosp UZA, Multidisciplinary Sleep Disorders Ctr, B-2650 Edegem, Belgium
[6] Antwerp Univ Hosp UZA, Pulm Med, B-2650 Edegem, Belgium
[7] Univ Antwerp, Fac Med & Hlth Sci, B-2020 Antwerp, Belgium
[8] Sint Lucas Andreas Hosp, Dept Otolaryngol Head & Neck Surg, Amsterdam, Netherlands
关键词
Obstructive sleep apnea/hypopnea syndrome; Sleep-disordered breathing; Supine-dependent; ORAL APPLIANCE THERAPY; MANDIBULAR ADVANCEMENT DEVICES; AIRWAY PRESSURE; PREVALENCE;
D O I
10.1007/s11325-014-1068-8
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The objective of this randomized controlled trial was to assess the additional effect of a chest-worn sleep position trainer (SPT) in patients with residual supine-dependent obstructive sleep apnea (sdOSA) under mandibular advancement device (MAD) therapy. Baseline and follow-up polysomnography with MAD were performed. Twenty patients with sdOSA under MAD therapy underwent two consecutive randomized polysomnographies: one with SPT and one with combination of SPT + MAD. Data are presented as median (quartile 1, quartile 3). The SPT reduced the time spent in supine sleeping position compared to baseline and MAD therapy. Both MAD and SPT were individually effective in reducing the overall apnea/hypopnea index (AHI) significantly when compared to baseline from 20.8 (15.1; 33.6)/h at baseline to 11.0 (6.7; 13.8)/h and to 11.1 (3.5; 17.7)/h with MAD or SPT, respectively. The combination of SPT + MAD further reduced the overall AHI to 5.7 (3.6; 7.4), which was significantly lower than with MAD alone (p < 0.001) and SPT alone (p < 0.008), respectively. The results of this study indicate that combination of SPT + MAD leads to a higher therapeutic efficacy in patients with sdOSA under MAD therapy when compared to one of the treatment modalities alone.
引用
收藏
页码:637 / 644
页数:8
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