Mandibular Advancement Device as a Comparable Treatment to Nasal Continuous Positive Airway Pressure for Positional Obstructive Sleep Apnea
| Autor: | Satoru Tsuiki, Hideaki Nakayama, Mina Kobayashi, Yuichi Inoue, Yoshikazu Takaesu, Yoko Komada |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Pediatrics animal structures Polysomnography medicine.medical_treatment Oral appliance Posture 03 medical and health sciences 0302 clinical medicine stomatognathic system Internal medicine medicine Humans Continuous positive airway pressure Sleep Apnea Obstructive Continuous Positive Airway Pressure business.industry food and beverages Middle Aged medicine.disease nervous system diseases respiratory tract diseases Obstructive sleep apnea Treatment Outcome 030228 respiratory system Neurology Commentary Cardiology Female Neurology (clinical) business Mandibular Advancement 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of Clinical Sleep Medicine. 12:1113-1119 |
| ISSN: | 1550-9397 1550-9389 |
| DOI: | 10.5664/jcsm.6048 |
| Popis: | Positional obstructive sleep apnea (P-OSA) is a clinically common phenotype of OSA, which can be treated effectively with mandibular advancement devices (MADs). We hypothesized that the efficacy of an MAD is comparable to that of nasal continuous positive airway pressure (nCPAP) in P-OSA patients.Among patients diagnosed with OSA at a single sleep center from January 2008 to May 2014, male subjects with moderate OSA were recruited and stringently categorized as having P-OSA when the ratio of their lateral apnea-hypopnea index (AHI) to supine AHI was ≤ 0.5, their lateral sleep time was60 minutes, and their lateral REM sleep time was longer than 10 minutes. Treatment efficacy was compared between P-OSA subjects with an MAD (n = 34) and those with nCPAP (n = 34) after matching for age, body-mass index, and baseline AHI.There were no significant differences in baseline AHI (MAD: nCPAP = 20.6 ± 3.9/h: 21.3 ± 1.7/h, p = 0.35) or in follow-up AHI (MAD: nCPAP = 4.7 ± 3.5/h: 3.4 ± 3.7/h, p = 0.12) between the 2 treatment groups, and hence MADs lowered the AHI to the same extent as nCPAP.These findings suggest that an MAD is as efficacious as nCPAP for P-OSA patients. MAD treatment for this specific phenotype may be a promising patient-tailored and first-line approach to OSA.A commentary on this article appears in this issue on page 1079. |
| Databáze: | OpenAIRE |
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