抄録
Introduction: Continuous positive airway pressure and oral appliances （OA） are typical treatments for obstructive sleep apnea （OSA）. There are many reports confirming the effect of OA by polysomnography （PSG） for improvement of OSA. However, many reports included only objective evaluations; few reports also evaluated subjective changes in sleep. Therefore, we investigated and compared the results of objective sleep tests before and after OA treatment with a subjective sleep questionnaire.
Method: We enrolled 99 consecutive patients with OSA who were diagnosed by PSG and answered the Pittsburgh Sleep Questionnaire （PSQI） from January 2016 to December 2017 at the Ota Memorial Sleep Center. As for the method, cases in which the apnea-hypopnea index （AHI） decreased to less than 5/h or more than 50% after wearing an OA were classified into the improved group, and the others were classified into the non-improved group. We compared each parameter before and after wearing the OA by statistical analysis. The parameters were PSQI, AHI, Non-REM AHI, REM AHI, total sleep time, sleep latency REM latency, sleep efficiency, sleep stage （Stage 1-3 + 4, REM） ratio, arousal time, total arousal index and respiratory-related arousal index.
Results: There were 60 cases in the improved group and 39 cases in the non-improved group. In the improved group, significant improvements of PSQI total score, sleep quality and sleepiness were observed after OA treatment. In the non-improved group, there was a significant subjective improvement of sleep onset time, difficulty sleeping and sleepiness after OA treatment. PSG results showed a significant decrease in AHI, Non-REM AHI, REM AHI, Stage 1, increase in Stage 2, and a decrease in respiratory-related arousal index in both groups. In the improved group, a significant increase in Stage REM, and a decrease in total arousal index and arousal time were observed.
Conclusion: Subjective sleep improved before and after OA treatment for OSA, regardless of improvement in AHI.
