睡眠時呼吸障害例に対するTongue Retaining Deviceの有効性-上気道圧値の変化-

Abstract

Sixteen patients who complained of snoring or obstructive sleep apnea were examined before and after the use of a tongue retaining device (TRD). The mean age of the patients was 53.4 years (range 33 to 64 years) and the mean body mass index (BMI) was 26.5 kg/m2 (range 22.5 to 30.8 kg/m2). The daytime polysomnography was performed with the use of zopiclone, and simultaneous monitoring of upper airway pressure in the epipharynx, mesopharynx, hypopharynx and esophagus (Peso) was carried out. The sites of obstruction during sleep were determined from the pressure radients among the four sensors. Analysis of the Peso and the apnea plus hypopnea indegx (AHI)were made with and without the TRD. The subjects were classified according to reductions in the Peso and AHI values. Five cases (group A) showed a 50% or more reduction in the Peso and AHI with the TRD. Four cases (group B) showed a 50% or more reduction of in the Peso with the TRD. Seven cases (group C) showed less than a 50% reduction in the Peso and AHI with the TRD. In group B, obstruction at the base of the tongue improved, but obstruction of the soft palate remained with the TRD. In group C, neither obstruction at the base of the tongue nor obstruction of the soft palate were improved with the TRD. The value of AHI was smaller in group A, when compared with values in groups B and C. These obsevations suggest that the TRD may be effective in patients with mild or moderate sleep dyspnea.