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

摘要: This paper, which has been reviewed and approved by the Board of Directors American Sleep Disorders Association, provides background for Standards Practice Committee's parameters practice sleep medicine in North America. The 21 publications selected this review describe 320 patients treated with oral appliances snoring obstructive apnea. modify upper airway changing posture mandible tongue. Despite considerable variation design these appliances, clinical effects are remarkably consistent. Snoring is improved often eliminated almost all who use appliances. Obstructive apnea improves majority patients; mean apnea-hypopnea index (AHI) group was reduced from 47 to 19. Approximately half achieved an AHI < 10; however, as many 40% those were left significantly elevated AHIs. Improvement quality sleepiness reflects effect on breathing. Limited follow-up data indicate that discomfort a common but tolerable side effect, dental mandibular complications appear be uncommon long-term compliance varies 50% 100% patients. Comparison risk benefit appliance therapy other available treatments suggests present useful alternative continuous positive pressure (CPAP), especially simple cannot tolerate CPAP therapy.