Study On The Changes Of Sleep And Respiratory Parameters In Patients With COMISA Treated With Oral Appliance

Objective:（1）To investigate the efficacy of oral appliance（OA）in the treatment of comorbid insomnia and obstructive sleep apnea（COMISA）.（2）To understand the difference of sleep and respiratory parameters between patients with COMISA and patients with Primary snoring before and after OA treatment.（3）To analyze the correlation between sleep parameters and respiratory parameters in patients with COMISA.Methods:（1）According to the inclusion criteria,14 patients with COMISA[6 males,8females,mean age（50.57±12.83）years old]were selected as the treatment group,and 17patients with primary snoring[10 males,7 females,mean age（41.35±13.93）years old]were selected as the control group.The sleep and respiratory parameters of polysomnography before treatment,one month after treatment and the control group were collected and compared.The efficacy of OA in the treatment of COMISA and the differences of sleep and respiratory parameters before and after treatment with primary snoring were analyzed.（2）38patients with COMISA in the non-treatment group were collected according to the inclusion criteria,and the correlation between sleep parameters and respiratory parameters before treatment was analyzed in 52 patients with COMISA in the treatment group and the non-treatment group.Results:（1）After OA treatment,sleep latency（SL）,arousal index（Ar I）,apnea index（AI）,apnea hypopnea index（AHI）and longest apnea time decreased（P<0.05）,while total sleep time（TST）,sleep efficiency（SE）,N3 phase percentage and the lowest arterial oxygen saturation（LSp O₂）increased in the treatment group（P<0.05）.（2）There were significant differences in sleep latency（SL）,apnea index（AI）,longest apnea time,N1 phase and N2phase between the treatment group and the control group before treatment and 1 month after treatment（P<0.05）,but there was no significant difference after treatment（P>0.05）.（3）Before COMISA treatment,apnea index（AI）and apnea hypopnea index（AHI）were positively correlated with REM sleep latency,and average arterial oxygen saturation（ASp O₂）was positively correlated with sleep latency（SL）（r=0.320,0.294,0.297）,while apnea index（AI）and apnea hypopnea index（AHI）were negatively correlated with the percentage of stage N3（r=-0.347,-0.325）.Conclusion:（1）Oral appliance is effective in the treatment of COMISA and can improve the symptoms of OSA and insomnia.（2）After Oral appliance treatment,the sleep structure of COMISA patients tended to be normal,and the sleep and respiratory parameters were improved,but there were still differences compared with the control group.（3）The occurrence of COMISA may be insomnia caused by obstructive sleep apnea.