Oral appliances for snoring and obstructive sleep apnea: a review.

摘要: We conducted an evidence-based review of literature regarding use oral appliances (OAs) in the treatment snoring and obstructive sleep apnea syndrome (OSA) from 1995 until present. Our structured search revealed 141 articles for systematic scrutiny, which 87 were suit- able inclusion evidence base, including 15 Level I to II random- ized controlled trials 5 these with placebo-controlled treat- ment. The efficacy OAs was established controlling OSA some but not all patients success (defined as no more than 10 apneas or hypopneas per hour sleep) achieved average 52% treated patients. Effects on sleepiness quality life also demonstrated, improvements other neurocognitive outcomes consistent. mechanism OA therapy is related opening upper airway demonstrated by imaging physiologic monitoring. Treatment ad- herence variable reporting using appliance a median 77% nights at 1 year. Minor adverse effects frequent whereas major uncommon. tooth movement small changes occlusion developed after prolonged use, long-term dental significance this uncertain. In comparison continuous positive pressure (CPAP), are less efficacious reducing hypopnea index (AHI), appear be used (at least self report), many studies preferred over CPAP when treatments compared. have been com- pared favorably surgical modification (uvulopalato- pharyngoplasty, UPPP). Comparisons between different designs produced findings. now provides better modality considerable guidance frequency indications UPPP. Citation: Ferguson KA; Cartwright R; Rogers R et al. Oral Appliances Snoring Obstructive Sleep Apnea: A Review. SLEEP 2006;29(2): 244-262.