Five-Year Subjective Outcomes of Obstructive Sleep Apnea Surgery: A Multiinstitutional Study
1
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Objectives. To evaluate the effect of obstructive sleep apnea (OSA) surgery on long-term (5-year) subjective outcomes, including sleep disordered breathing (SDB) symptoms and other complications, in patients with OSA. Methods. We enrolled patients who underwent diagnostic polysomnography for OSA between January 2006 and December 2006 in ten hospitals. Patients either were treated for OSA or were not treated for OSA. All patients completed a brief telephone survey regarding their SDB signs and symptoms (e.g., snoring, apnea, nocturnal arousals, and daytime sleepiness), positive airway pressure (PAP) compliance, and any adverse effects of either the surgery or PAP. A positive subjective outcome for either surgery or no treatment was taken to be the alleviation of apnea, defined as a ≥50% increase in score. A positive subjective outcome (compliance) for PAP was defined as a PAP usage of ≥4 hours per night and ≥5 days per week. Results. A total of 229 patients were included in this study. Patients were divided into three groups: a surgery group (n=87), a PAP group (n=68), and a control (untreated) group (n=74). The surgery group exhibited significant improvement in all SDB symptoms compared with the control group. The long-term subjective outcomes of the surgery (52.9%) and PAP (54.4%) groups were significantly better than those of the control group (25.0%). The subjective outcome of the surgery group was not significantly different from that of the PAP group. The overall surgical complication rate was 23.0% (20 of 87) in the surgery group, and 55.0% (22 of 40) of all patients with PAP experienced adverse effects. Conclusion. The extent of SDB symptoms was consistently improved in patients with OSA at 5 years postsurgery. Information about the potential long-term subjective outcomes should be provided to patients when considering surgery.
Abstract
Objectives. To evaluate the effect of obstructive sleep apnea (OSA) surgery on long-term (5-year) subjective outcomes, including sleep disordered breathing (SDB) symptoms and other complications, in patients with OSA. Methods. We enrolled patients who underwent diagnostic polysomnography for OSA between January 2006 and December 2006 in ten hospitals. Patients either were treated for OSA or were not treated for OSA. All patients completed a brief telephone survey regarding their SDB signs and symptoms (e.g., snoring, apnea, nocturnal arousals, and daytime sleepiness), positive airway pressure (PAP) compliance, and any adverse effects of either the surgery or PAP. A positive subjective outcome for either surgery or no treatment was taken to be the alleviation of apnea, defined as a ≥50% increase in score. A positive subjective outcome (compliance) for PAP was defined as a PAP usage of ≥4 hours per night and ≥5 days per week. Results. A total of 229 patients were included in this study. Patients were divided into three groups: a surgery group (n=87), a PAP group (n=68), and a control (untreated) group (n=74). The surgery group exhibited significant improvement in all SDB symptoms compared with the control group. The long-term subjective outcomes of the surgery (52.9%) and PAP (54.4%) groups were significantly better than those of the control group (25.0%). The subjective outcome of the surgery group was not significantly different from that of the PAP group. The overall surgical complication rate was 23.0% (20 of 87) in the surgery group, and 55.0% (22 of 40) of all patients with PAP experienced adverse effects. Conclusion. The extent of SDB symptoms was consistently improved in patients with OSA at 5 years postsurgery. Information about the potential long-term subjective outcomes should be provided to patients when considering surgery.
참고문헌 (16)
- American Academy of Sleep Medicine, "International classification of sleep disorders. 3rd ed" (2014), American Academy of Sleep Medicine;
- Epstein LJ, "Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults", J Clin Sleep Med, 5(3), pp.263~276 (2009)
- White DP, "Obstructive sleep apnea", Compr Physiol, 2(4), pp.2541~2594 (2012)
- Yaggi HK, "Adult obstructive sleep apnea", hypopnea syndrome: definitions, risk factors, and pathogenesis, 2010, pp.31(2), 179~186
- Selim B, "Cardiovascular consequences of sleep apnea", Clin Chest Med, 31(2), pp.203~220 (2010)
- Kushida CA, "Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders", Sleep, 29(3), pp.375~380 (2006)
- Kakkar RK, "Positive airway pressure treatment for obstructive sleep apnea", Chest, 132(3), pp.1057~1072 (2007)
- Aurora RN, "Practice parameters for the surgical modifications of the upper airway for obstructive sleep apnea in adults", Sleep, 33(10), pp.1408~1413 (2010)
- Sher AE, "The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome", Sleep, 19(2), pp.156~177 (1996)
- Weaver EM, "Studying Life Effects & Effectiveness of Palatopharyngoplasty (SLEEP) study: subjective outcomes of isolated uvulopalatopharyngoplasty", Otolaryngol Head Neck Surg, 144(4), pp.623~631 (2011)
- 최지호, "Effect of Isolated Uvulopalatopharyngoplasty on Subjective Obstructive Sleep Apnea Symptoms", Clinical and Experimental Otorhinolaryngology, 6(3), pp.161~165 (2013), 대한이비인후과학회
- Goh YH, "Quality of life 17 to 20 years after uvulopalatopharyngoplasty", Laryngoscope, 117(3), pp.503~506 (2007)
- Robinson S, "Upper airway reconstructive surgery long-term quality-of-life outcomes compared with CPAP for adult obstructive sleep apnea", Otolaryngol Head Neck Surg, 141(2), pp.257~263 (2009)
- Lojander J, "Lehtonen H. Nasal-CPAP, surgery, and conservative management for treatment of obstructive sleep apnea syndrome. A randomized study", Chest, 110(1), pp.114~119 (1996)
- Caples SM, "Surgical modifications of the upper airway for obstructive sleep apnea in adults: a systematic review and meta-analysis", Sleep, 33(10), pp.1396~1407 (2010)
- Riley RW, "Maxillofacial surgery and nasal CPAP. A comparison of treatment for obstructive sleep apnea syndrome", Chest, 98(6), pp.1421~1425 (1990)