睡眠時無呼吸症候群に対する歯科外来での治療経験

Obstructive sleep apnea, OSA is a syndrome in which nasal and oral airflow ceases in spite of continued diaphragmatic efforts. This syndrome occurs during sleep and is brought about by a collapse or other obstruction in the upper airway. Because OSA prevents air from entering the lungs, it produces a rapid decrease in circulating blood oxygen levels. If the blood oxygen saturation level drops, the cardiovascular system reacts quickly in an effort to increase blood flow. As a result, OSA patients are frequently hypertensive and often exhibit dangerous cardiac arrhythmias. Other complications include the development of severe daytime sleepiness, loud snoring and disturbed nighttime sleep.
Oral appliance, OA is a popular non-surgical method for treatment of sleep apnea. The OA, used in our clinic, consisted of separate lower and upper full coverage acrylic appliances, which were connected with two rod and tube devices. This device advanced the mandible and allow for opening, protrusive and some side-to-side movement, but no retrusive movement. The OA was worn during sleep and supposedly increases airway caliber and decrease airway resistance. This report introduces the clinical know-how of OA treatment for OSA patients.