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

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

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。

 

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.