成人阻塞性睡眠中止症的極微侵入性治療

Abstract

睡眠呼吸中止症候群是成人常見的睡眠障礙疾病，病人在睡眠期間會反覆的發生上呼吸道的阻塞，進而產生睡眠品質不良及其他健康相關疾病。最常見的治療為正壓呼吸器，但是有部分病人因為噪音等接受度不好。其他的治療方式包含口內止鼾器，呼吸道相關手術等，多數研究顯示治療效果良好，且病人接受度佳。此篇系統性文獻回顧以網絡統合分析的方式在探討成人睡眠呼吸中止症候群的極微侵入性治療效果。本研究經由 Embase、Medline、Pubmed 以及 Cochrane 資料庫進行系統性文獻回顧，只選用隨機分派對照試驗。研究結果顯示在評估各種治療的效果後，建議以正壓呼吸器治療效果最佳，口內止鼾器可有效地用在治療無法接受正壓呼吸器的病人。

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common sleep disorder in adults. The aim of this study was to develop a systematic review and a Bayesian network meta-analysis to compare the objective and subjective outcomes of different minimally-invasive treatments in adult OSAHS patients. An electronic literature search was performed via Ovid within Embase, MEDLINE (via PubMed), and Cochrane databases. Only randomized-controlled trials were included in this study. Interventions for OSAHS including continuous positive airway pressure (CPAP), mandibular advancement device (MAD), surgeries under local anesthesia etc. were compared using Bayesian network meta-analyses. Our results demonstrated the superiority of CPAP over other minimally-invasive treatments in OSAHS patients with moderate to severe OSAHS. MAD may be the clinically effective alternative to CPAP in patients denying CPAP.