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수면호흡장애 환자에서 구강 내 장치의 성공적인 치료와 관련된 수면다원검사 지표들

Polysomnographic Parameters Related to the Successful Treatment of Oral Appliance in Patients with Sleep-Disordered Breathing

대한이비인후과학회지-두경부외과학
2012년 55권 12호 p.771 ~ p.776
김영하 ( Kim Young-Ha ) - 가톨릭대학교 의과대학 여의도성모병원 이비인후-두경부외과학교실

박동선 ( Park Dong-Sun ) - 숨수면센터
손동화 ( Son Dong-Hwa ) - 숨수면센터
조진희 ( Cho Jin-Hee ) - 가톨릭대학교 의과대학 여의도성모병원 이비인후-두경부외과학교실

Abstract

Background and Objectives: The use of oral appliances has recently risen as an effective alternative treatment methods for patients with simple snoring or mild to moderate obstructive sleep apnea, who prefer oral appliances to continuous positive airway pressure (CPAP) or who are unable to tolerate CPAP therapy. The objective of this study was to identify which polysomnographic parameters are related to the successful use of oral appliances in patients with sleep-disordered breathing.

Subjects and Method: We performed a retrospective study of 29 subjects with sleep-disordered breathing and prescribed the use of an oral appliance. To determine which polysomnographic parameters were related to responsiveness to oral appliances, differences in responder rates were assessed according to apnea severity, sleep position, rapid eye movement-stage dependency, body mass index (BMI) and nasal surgery history.

Results: Twenty-one of 29 patients showed improved respiratory disturbance index after oral-appliance treatment. Responder rates of patients with mild, moderate, and severe sleep-disordered breathing were 72.3%, 80%, and 62.5%, respectively. Responder rates among position-dependent and non-position dependent groups were 85% and 44.4%, respectively. When grouping into overweight and normal weight groups according to BMI, responder rates were 69.57% and 83.3%, respectively. The responder rate for 24 patients who had undergone septoturbinoplasty was 75%, whereas it was 60% for the non-surgery group.

Conclusion: Oral appliance therapy is confirmed to be useful for patients with simple snoring or mild to moderate sleep apnea, or position dependent sleep apnea, and those who have normal weight and low nasal resistance.

키워드

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학술진흥재단(KCI) KoreaMed 대한의학회 회원 
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