在重度阻塞性睡眠呼吸暂停时,部推进装置与CPAP相比
J T Colpani1, Y-H Ou2, A M Kosasih2
1Discipline of Endodontics, Operative Dentistry and Prosthodontics, Faculty of Dentistry, National University of Singapore, Singapore.
Journal of dental research
|September 1, 2025
概括
在重度阻塞性睡眠呼吸暂停 (OSA) 患者中,部推进装置 (MAD) 有效降低了血压. 虽然MAD和持续正气压 (CPAP) 改善了生活质量,但MAD对血压控制的影响更大.
科学领域:
- 心脏病学
- 睡眠医学
- 呼吸系统医学
背景情况:
- 严重的阻塞性睡眠呼吸暂停 (OSA) 与心血管风险增加有关.
- 持续的正气道压力 (CPAP) 是主要的治疗方法,但坚持可能是具有挑战性的.
- 部推进装置 (MAD) 提供了OSA的替代治疗选择.
研究的目的:
- 为了比较MAD与CPAP在治疗严重OSA患者的心血管参数和生活质量的有效性.
- 评估MAD和CPAP对24小时门诊血压,心肌重塑,心律和生物标志物的影响.
主要方法:
- 一个随机试验的子研究,涉及144名严重的OSA参与者,随机分配到MAD (n=73) 或CPAP (n=71) 12个月.
- 评估了24小时的门诊血压,睡眠相关的生活质量 (包括爱普沃思睡眠量表),心脏MRI参数,门诊心律和生物标志物.
- 记录了每晚使用和坚持设备的情况.
主要成果:
- 与基线相比,MAD治疗显著降低了睡眠中的平均血压,缩血压和腹缩血压.
- CPAP没有显示睡眠血压的显著变化.
- 两组间的分析表明,MAD可以降低睡眠中的平均血压和静脉压.
- 这两种装置都改善了与睡眠有关的生活质量,CPAP在爱普沃思睡眠量表上显示出略有更大的效果.
- 没有观察到心脏MRI,心律或生物标志物的显著变化.
- MAD与下巴疼痛和牙不适有关,而CPAP使用者报告口腔干燥,鼻塞和空气泄漏.
结论:
- 部推进装置 (MAD) 是一种可接受且有效的严重阻塞性睡眠呼吸暂停 (OSA) 治疗方法,特别是在高血压患者中降低血压.
- 无论是MAD还是CPAP,都能改善睡眠相关的生活质量,但MAD在血压管理方面具有明显的优势.
- 这些发现支持将MAD作为CPAP的可行替代品,适用于严重的OSA和高血压患者.
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