第三大臼歯手術が若年成人の睡眠健康パラメータに及ぼす影響：観察研究

Effect of Third Molar Surgery on Sleep Health Parameters of Young Adults: An Observational Study.

抄録

:第三大臼歯の外科的抜歯は、最も一般的な口腔外科処置の1つであるが、患者の睡眠の質における役割は依然として不明である。本研究の目的は、第三大臼歯の外科手術後の患者報告による睡眠の健康状態の変化を評価し、睡眠パラメータと抜歯後の疼痛との関連性を調査することである。参加者全員が睡眠日誌、Epworth Sleepiness Scale（ESS）、Pittsburgh Sleep Quality Index（PSQI）、Athens Insomnia Scale（AIS）の質問票に記入し、抜歯前後1週間の睡眠習慣、日中の眠気、睡眠の質、不眠の重症度を評価した。さらに、術後には痛みの知覚を評価するために視覚的アナログスケールを記入した。研究プロトコルを完了した75人の患者のうち、男性32人（42.7％）、女性43人（57.3％）、平均年齢は24.01歳（±3.43歳）であった。術後、PSQI［術前4.85（±2.32） vs. 術後5.39（±2.75）、= 0.041］、AIS［術前5.56（±3.23） vs. 術後6.91（±4.06）、< 0.001］、夜間覚醒の週平均回数［覚醒前2.01（±3.72） vs 覚醒後4.19（±5.20）、＜0.001］は増加したが、ESS、週平均睡眠時間、週平均入眠潜時は増加しなかった。第3大臼歯の手術は、抜歯後1週間の睡眠の質と不眠症の重症度に影響を与えるが、日中の眠気には影響を与えない。抜歯後の自覚的睡眠症状の悪化は、痛みの知覚の増加と関連している可能性がある。

: The role of surgical extraction of the third molar in patients' sleep quality remains unclear, although it is one of the most common oral surgical procedures. The aim of this study is to assess the changes in patient-reported sleep health outcomes after third molar surgery and to investigate any associations between sleep parameters and post-extraction pain. : Young adults without known comorbidities who were in need of mandibular third molar surgical extraction were included. All participants completed a sleep diary, the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and Athens Insomnia Scale (AIS) questionnaires, which were used to assess sleep habits, daytime sleepiness, sleep quality and insomnia severity one week before and after extraction. In addition, a visual analog scale was completed postoperatively to assess the perception of pain. : Out of 75 patients who completed the study protocol, 32 (42.7%) were males and 43 (57.3%) were females, with a mean age of 24.01 (±3.43) years. Postoperatively, statistically significant higher scores were observed for PSQI [4.85 (±2.32) before vs. 5.39 (±2.75) after, = 0.041], AIS [5.56 (±3.23) before vs. 6.91 (±4.06) after, < 0.001] and average weekly number of nocturnal awakenings [2.01 (±3.72) before vs. 4.19 (±5.20) after, < 0.001] but not for ESS, average weekly sleep duration and average weekly sleep onset latency. Pain perception was increased in patients who slept worse on almost all seven postoperative days, although this did not reach statistical significance. : Third molar surgery impacts sleep quality and insomnia severity in the first week after extraction, while there is no effect on daytime sleepiness. The worsening of subjective sleep symptoms after extraction may be associated with an increased perception of pain.