肌功能治疗阻塞性睡眠呼吸暂停的有效性:系统性审查和网络元分析
Ying Xu1, Ruicong Yang1, Min Yu1
1Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, PR China; Center for Oral Therapy of Sleep Apnea, Peking University Hospital of Stomatology, Beijing, PR China.
The journal of evidence-based dental practice
|July 27, 2025
概括
肌功能疗法 (MT) 是阻塞性睡眠呼吸暂停 (OSA) 的辅助治疗方法,显著改善成人主观睡眠质量. 每天MT超过30分钟也可以改善呼吸暂停-呼吸暂停指数 (AHI).
科学领域:
- 睡眠医学 睡眠医学
- 呼吸系统医学 呼吸系统医学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 是一种普遍存在的睡眠障碍,对健康有重大影响.
- 肌功能疗法 (MT) 越来越多地被探索为OSA的非侵入性辅助治疗.
- 关于MT在不同年龄组的有效性及其对客观和主观OSA指标的影响的证据需要系统评估.
研究的目的:
- 系统地审查并进行随机对照试验 (RCT) 的网络元分析,以评估MT对成人和儿科OSA的疗效.
- 评估MT对客观 (如AHI) 和主观 (如ESS,PSQI) 睡眠呼吸暂停参数的影响.
- 确定MT的潜在益处,包括特定的协议和与其他疗法的组合.
主要方法:
- 在四个电子数据库中进行系统的文献搜索,截至2024年4月30日.
- 包括15个RCT (473名成年人,139名儿童);10个成年人研究 (n=380) 被纳入网络元分析.
- 多变量随机效应元分析和网络元分析,以估计睡眠呼吸暂停指标的聚合差异.
主要成果:
- 在成年人中,MT显著改善了主观睡眠质量,埃普沃思睡眠度量 (ESS) 和匹兹堡睡眠质量指数 (PSQI) 的降低证明了这一点.
- 对于成年人单独的MT,没有观察到呼吸暂停-呼吸暂停指数 (AHI) 的统计学显著变化,尽管在兴奋指数和打方面有所改善.
- 有限的证据表明,MT在儿科OSA中可能有利于AHI和氧和度 (SpO2),高度遵守是至关重要的. 将MT与CPAP结合使用显示出降低AHI的潜力,但没有提高CPAP的疗效.
结论:
- MT是一种有前途的辅助疗法,可以改善成年OSA患者的主观睡眠指标.
- 每天超过30分钟的MT显示出可以显著改善呼吸暂停-呼吸暂停指数 (AHI) 的潜力.
- 特定的MT协议,如MTSP和MT结合肌肌释放,可能为主观结果提供额外的好处.
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