단순 코골이와 경증 폐쇄성수면무호흡의 치료 결과와 치료 방법에 대한 임상적 평가 = Therapeutic Outcome of Primary Snoring and Mild Obstructive Sleep Apnea and Clinical Suggestion for Treatment Approaches

다국어 초록 (Multilingual Abstract)

Background and Objectives The clinical significance and need for the treatment of primary snoring and mild obstructive sleep apnea have been recently questioned. In this study, we analyzed therapeutic outcome and the methods of treatment of such diseases.
Subjects and Method A retrospective review was conducted using the medical records of patients diagnosed with primary snoring or mild obstructive sleep apnea at a single institution from 2013 to 2015 through polysomnography or WATCHPAT.
Results Of the 18 patients (37%) with primary snoring, 13 patients (72.2%) underwent surgery, four patients (22.2%) were treated with surgery and mandibular advancement device, and one patient (5.6%) underwent automatic positive airway pressure therapy. Of the 78 patients (61%) with mild obstructive sleep apnea, 35 patients (44.8%) had surgery, 24 patients (30.8%) were treated with mandibular advancement device, 13 patients (16.7%) were treated with surgery and mandibular advancement device and 6 patients (7.7%) received automatic positive airway pressure therapy. For primary snoring, while Epworth Sleepiness Scale and Pittsburg Sleep Quality Index did not improve, the snoring visual analog scale decreased significantly. In patients with mild obstructive sleep apnea, Apnea-Hypopnea Index, snoring decibel, Epworth Sleepiness Scale, and Pittsburg Sleep Quality Index were significantly decreased after treatment and the lowest oxygen saturation was significantly increased after treatment.
Conclusion For primary snoring, the direction of treatment should be determined in accordance with the presence of associated diseases related to sleep disturbance breathing. For mild obstructive sleep apnea, active treatment may be helpful.

참고문헌 (Reference)

1 오정은, "습관적 코골이와 관련된 요인" 대한임상건강증진학회 11 (11): 18-24, 2011

2 American Academy of Sleep Medicine Task Force, "Sleep-related breathing disorders in adults : recommendations for syndrome definition and measurement techniques in clinical research" 22 (22): 667-689, 1999

3 Banno K, "Sleep apnea : clinical investigations in humans" 8 (8): 400-426, 2007

4 Heinzer R, "Prevalence of sleep-disordered breathing in the general population : the HypnoLaus study" 3 (3): 310-318, 2015

5 Olafsdottir R, "Prevalence of sleep apnoea syndrome in the middle to old age general population" 4 (4): e5-6, 2016

6 Deegan PC, "Pathophysiology of obstructive sleep apnoea" 8 (8): 1161-1178, 1995

7 Marklund M, "Oral appliance therapy in patients with daytime sleepiness and snoring or mild to moderate sleep apnea : a randomized clinical trial" 175 (175): 1278-1285, 2015

8 Arnardottir ES, "Obstructive sleep apnoea in the general population : highly prevalent but minimal symptoms" 47 (47): 194-202, 2016

9 Quan SF, "Lack of impact of mild obstructive sleep apnea on sleepiness, mood and quality of life" 9 (9): 44-56, 2014

10 Galic T, "Improvement of cognitive and psychomotor performance in patients with mild to moderate obstructive sleep apnea treated with mandibular advancement device : a prospective 1-year study" 12 (12): 177-186, 2016

11 Luz GP, "Impaired sustained attention and lapses are present in patients with mild obstructive sleep apnea" 20 (20): 681-687, 2016

12 Kezirian EJ, "Drug-induced sleep endoscopy : the VOTE classification" 268 (268): 1233-1236, 2011

13 Lisi E, "Diastolic dysfunction in controlled hypertensive patients with mild-moderate obstructive sleep apnea" 187 : 686-692, 2015

14 Benoist L, "A randomized, controlled trial of positional therapy versus oral appliance therapy for positiondependent sleep apnea" 34 : 109-117, 2017

15 Quinnell TG, "A crossover randomised controlled trial of oral mandibular advancement devices for obstructive sleep apnoeahypopnoea(TOMADO)" 69 (69): 938-945, 2014