Clinical Analysis Of Oropharyngeal Rehabilitation In Patients With Obstructive Sleep Apnea Hypopnea Syndrome

Background: Obstructive sleep apnea hypopnea syndrome(OSAHS)is a heterogeneous disease,and its pathophysiology mechanism can be divided into anatomical factors and non-anatomical factors.Among them,improving the function of upper airway dilator muscle during sleep through oral-facial muscle rehabilitation exercise is a research hotspot in recent years.Objective: To explore the clinical effect of Oropharyngeal rehabilitation(OPR)on patients with OSAHS.Method: In this prospective study,patients diagnosed with OSAHS from July 2022 to December 2022 in the Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Nanchang University were included.At the same time,the patients’ age,weight,height,neck circumference,abdominal circumference,smoking history and other basic data were collected.The ESS sleepiness scale,Berlin Score and PSQI sleep quality score were used to evaluate the patients’ clinical symptoms.The results of the first PSG and cervical ultrasound examination were recorded.According to the gender,age and severity of the disease,the patients were divided into male and female group,< 50 years old and ≥50 years old group,moderate and severe group.After 1 month of OPR treatment,the clinical symptoms,PSG,and cervical ultrasound were evaluated again.Finally,the above examination results were statistically analyzed.Results: A total of 24 patients were included in the initial study,of which 12 patients completed 1-month follow-up OPR,with 6 patients in mild to moderate and6 patients in severe.First,compared with baseline,AHI was significantly improved after OPR treatment(41.27±23.99 times /h VS 32.28±23.30 times /h,P < 0.05),and AHI was significantly improved by a decrease in NREM-AHI and a significant change in hypopnea index.However,there were no significant changes in other PSG results such as obstructive index,mean heart rate at night,oxygen decreasing index(ODI),mean blood oxygen saturation,and minimum blood oxygen saturation.Secondly,there were no significant changes in symptoms,cervical ultrasonography,and PSG evaluation in mild to moderate patients before and after treatment,while there were significant changes in blood pressure and AHI in severe patients(P < 0.05),and significant changes in NREM-AHI(P=0.004).Patients < 50 years old had significant changes in AHI before and after treatment(P=0.046),and patients ≥50years old had significant changes in transverse diameter of posterior palatal space before and after treatment(P=0.046).Then,in terms of compliance,women had higher compliance than men(median: 5.00 vs 2.50,P=0.045).In terms of compliance group,there was no significant difference in symptoms of different gender,age,and severity among the 24 patients enrolled.Finally,correlation analysis suggested that snoring frequency was related to the improvement of pharyngeal wall thickness,the change of AHI after treatment was not related to general data,symptoms and other indicators of PSG results,but was related to the change of pharyngeal wall thickness(r=-0.759,P=0.004),and the change of AHI in elderly patients was related to the change of pharyngeal wall thickness.Conclusions: In the short term,OPR can significantly improve the severity and snoring symptoms of OSAHS patients,and may become an effective alternative therapy.