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Doctoral Thesis
DOI
10.11606/T.25.2019.tde-24012019-095137
Document
Author
Full name
Sílvia de Carvalho Alvarenga
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2018
Supervisor
Committee
Peres, Sílvia Helena de Carvalho Sales (President)
Janson, Guilherme dos Reis Pereira
Leite, Celso Vieira de Souza
Weber, Silke Anna Thereza
Title in Portuguese
Eficiência do aparelho intraoral no tratamento da síndrome da apneia obstrutiva do sono em obesos grau III
Keywords in Portuguese
Aparelho intraoral de avanço mandibular
Apneia obstrutiva do sono
Obesidade
Abstract in Portuguese
Os aparelhos intraorais (AIOs) de avanço mandibular, têm sido sugeridos como tratamentos alternativos aos intolerantes ou não aderentes à pressão positiva contínua nas vias aéreas (CPAP), no entanto não há estudos que avaliem a efetividade de AIO em pacientes obesos grau III, população bastante afetada pela presença de SAOS. Por isso este ensaio clínico randomizado teve por objetivo avaliar a melhora na qualidade de sono, qualidade de vida, sonolência diurna e gravidade de SAOS, antes e após o uso de AIO, comparado com o uso da placa ajustável de silicone, em pacientes com grau III de obesidade. A amostra foi composta por quarente e cinco pacientes com AOS leve/moderada/severa, foram aleatoriamente divididos em dois grupos paralelos: AIO e controle passivo (placa ajustável de silicone). Foram aplicados questionários relativos à qualidade de vida, presença de sonolência diurna excessiva e qualidade do sono e também foram submetidos a exames de polissonografia antes do início e depois de 45 dias de uso do tratamento. Não houve diferença significativa nas variáveis idade e medidas antropométricas entre grupos (p<0,001). Diferenças foram encontradas na qualidade de vida, sonolência diurna e qualidade do sono, em favor do tratamento com AIO (p<0,001) e houve melhora significativa no índice de apneia-hipopneia (IAH) entre o baseline e pós-tratamento no grupo AIO (p<0,001). Pode-se concluir que o AIO proposto foi eficiente e pode ser considerado tratamento alternativo ou coadjuvante viável da SAOS em pacientes obesos grau III.
Title in English
Efficiency of intraoral appliance in the treatment of obstructive sleep apnea syndrome in grade III obeses
Keywords in English
Obesity
Obstructive sleep apnea
Oral appliance
Abstract in English
Intraoral appliances (AIOs) of mandibular advancement have been suggested as alternative treatments to those intolerant or non-adherent to continuous positive airway pressure (CPAP); however, there are no studies evaluating the effectiveness of AIO in grade III obese patients, population affected by the presence of OSAS. Therefore, this randomized clinical trial aimed to evaluate the improvement in sleep quality, quality of life, daytime sleepiness and OSAS severity, before and after the use of AIO, compared to the use of adjustable silicone plaques in patients with grade III of obesity. The sample consisted of forty-five patients with mild / moderate / severe OSA, were randomly divided into two parallel groups: AIO and passive control (adjustable silicone plaque). Questionnaires related to quality of life, excessive daytime sleepiness and sleep quality were applied and polysomnography examinations were also performed before and after 45 days of treatment. There was no significant difference in the variables age and anthropometric measurements between groups (p <0.001). Differences were found in quality of life, daytime drowsiness and sleep quality in favor of AIO treatment (p <0.001) and there was a significant improvement in apnea-hypopnea index (AHI) between the baseline and post-treatment in the AIO group (p <0.001). It can be concluded that the proposed AIO was efficient and could be considered a viable alternative or adjuvant treatment of OSAS in grade III obese patients.
 
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Publishing Date
2019-01-25
 
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