不同壓舌結構長度之氣流干擾式止鼾牙套對於打鼾的改善比較：
以手機應用程式偵測一位中年男性為例
 
高以信¹　林彥璋²　何瑪丹²　曾筱甯²　江瑞坤³

 目的：睡眠呼吸中止症與成人打鼾息息相關。以手機應用程式偵測打鼾是一簡單可行的方法。本文的目的是以手機應用程式偵測來探討不同壓舌長度之氣流干擾式止鼾牙套對於打鼾的改善比較。
方法：病人為一中年男性，使用兩種不同壓舌結構長度（2cm 與3cm版）的氣流干擾式止鼾牙套，對於打鼾的改善程度，使用華碩Zenphone 2搭配snoreclock應用程式每晚監測打鼾情形。此應用程式可以匯出打鼾紀錄的結果，輸出的變項包括：記錄次數、平均睡眠時間、打鼾時間、打鼾的分貝數、最大打鼾分貝數、打鼾時間比率。
結果：在此病人的研究中，共記錄了122筆的手機打鼾應用程式紀錄的結果，其中42筆是使用壓舌結構為2cm 版的牙套，80筆是3cm 版的牙套。相對於壓舌結構長度為2cm 組牙套，壓舌結構長度為3cm 組牙套平均最大打鼾分貝數顯著減少7.7分貝(21.5±15.5 vs. 29.2±7.1, p=0.012)，平均打鼾分貝數顯著減少4.3分貝(9.4±6.5 vs. 13.7±3.0, p<0.001)，打鼾時間顯著減少約五分之四(0.2±0.2 vs. 1.0±0.8, p<0.001)，平均打鼾時間比率(%)顯著減少(3.2±3.6 vs. 14.2±11.0, p<0.001)，以及平均打鼾時間比率在>5%、>10%、>15%者也都有顯著的減少。
結論：在此病人的研究中發現使用氣流干擾式止鼾牙套的壓舌結構3cm 版較2cm 版，在平均最大打鼾分貝數，平均打鼾分貝數，平均打鼾時間，以及平均打鼾時間比率皆有顯著的改善。期許未來有更多大型的研究可以再擴充此結果。
（台灣家醫誌2019; 29: 105-111）DOI: 10.3966/168232812019062902006
 
關鍵詞：止鼾牙套、打鼾、手機應用程式
 

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¹台南市立醫院（委託秀傳醫療社團法人經營）家庭醫學部、²自然牙醫診所、³大林慈濟醫院家庭醫學部
受理日期：108年1月28日　　修改日期：108年3月14日　　同意刊登：108年4月16日
通訊作者：江瑞坤　　　　　通訊地址：嘉義縣大林鎮民生路2號

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 The Efficacy of a Registered Airflow-interference-type Nasal Congestion Relieving and Snore-Ceasing Oral Appliance
with Pressing Structures of Different Lengths: A Case Report for Use of a Snoring App in a Middle-aged Male
 
Yee-Hsin Kao¹, Yen-Chang Lin², Madan Ho², Hsiao-Ning Tzeng²and Jui-Kun Chiang³

 
Purpose:Sleep apnea is closely related to snoring in adults. Using smartphone snoring apps is a simple and feasible option for monitoring snoring. This study utilized a smartphone snoring app to detect differences in snoring improvement when using a registered oral appliance (named tonguepressing airflow-interference-type nasal congestion relief device) with tongue pressing structures of different lengths.
Methods: A middle-aged male patient was instructed to wear two different types of a registered oral appliance (lengths of pressing structure 2 cm and 3 cm) for measuring his snoring every night using a smartphone (Asus Zenphone 2) installed with the app Snoreclock that output the following variables: frequency, average sleep duration, snoring duration, snoring loudness (dB), maximum snoring loudness (dB), and ratio of snoring duration (%).
Results:A total of 122 results were obtained from the application. Among them, 42 records were from the patient wearing the 2-cm version of the device, and 80 from the patient wearing the 3-cm version. Compared with those obtained from the 2-cm version, the loudest snore from the 3-cm version was 7.7 dB lower (21.5±15.5 vs. 29.2±7.1, p=0.012), the average snoring loudness was 4.3 dB lower (9.4±6.5 vs. 13.7±3.0, p<0.001), the snoring duration was approximately 80% lower (0.2±0.2 vs. 1.0±0.8, p<0.001), and their ratio of snoring duration was also significantly lower (3.2±3.6 vs. 14.2±11.0, p<0.001). Additionally, the proportions of the patient’s records which occurred when the average ratio of snoring duration were >5%, >10%, and >15% were all substantially reduced.
Conclusion: Compared with using this registered oral appliance with a 2-cm tongue pressing structure, using the 3-cm version substantially lowers the average loudest snore, average snoring loudness, average snoring duration, and average ratio of snoring duration. In the future, largerscale studies should be conducted to enrich the results of the present one.
(Taiwan J Fam Med 2019; 29: 105-111) DOI: 10.3966/168232812019062902006
 
Key words:oral appliance, smartphone snoring apps, snoring
 

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¹Department of Family Medicine, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan; ²Nature Dental Clinic, Puli Township, Nantou; 3Department of Family Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
Received: January 28, 2019; Revised: March 14, 2019; Accepted: April 16, 2019.