簡介
睡眠問題在現代社會逐漸嚴重，多數人將其歸因於工作壓力和生活習慣的改變。根據統計，每兩人中就有一人面臨睡眠障礙，其中40％~50％的男性睡眠困擾與呼吸問題相關。失眠困擾更是普遍存在，且部分人同時面臨多種睡眠問題，使得治療變得複雜。

為解決這一現象，醫院特設「睡眠中心」，提供舒適環境和全方位的睡眠健康檢查及治療服務。不同於一般睡眠檢查中心，我們的中心從釐清病因、制定治療計畫到提供治療服務，提供一貫化流程的完整醫療資源。結合各專業科別的醫師團隊，使用最新的檢查儀器進行全面紀錄，由團隊醫師詳細解讀報告，找出影響睡眠的生理因素，制定後續治療計畫。為協助失眠困擾者，引進國外廣泛應用的睡眠認知行為治療，結合專業睡眠心理師，全面解決睡眠障礙。同時，設置專業案例管理師，協助安排後續治療和追蹤，提供每位來賓貼心的服務，全面照護睡眠。

睡眠中心注重「身」、「心」睡眠醫療照護特色和人性化服務，讓檢查和治療成為一種享受。這一綜合性的解決方案旨在提高人們的生活品質，改善整體健康水平。 

特色
  1. 檢查評估與治療並重。
  2. 一貫化流程，減少轉診與等待的時間，獲得更好的醫療服務品質。
  3. 整合型醫療團隊，提供詳盡報告解說。 
  4. 專業各案管理師安排後續治療及追蹤。 
  5. 貼心服務，提供專業設計的檢查環境。
本中心致力於提供最佳的環境，讓您在檢查或治療過程中感受到溫馨和舒適。我們擁有先進的檢查儀器，這些儀器將為您揭開睡眠的神秘面紗，使我們的醫療團隊能更全面地了解您的睡眠情況，搭配先進的治療儀器，以幫助您有效解決睡眠困擾。

我們的設施和醫療團隊的協同作業旨在提供全方位、先進的睡眠健康服務。
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Take this medication by mouth as directed by your doctor, usually 2 or 3 times a day with a full glass of water (8 ounces/240 milliliters). Do not lie down for at least 10 minutes after taking this drug. To prevent stomach upset, take this medication with food, milk, or an antacid.
For certain conditions (such as arthritis), it may take up to two weeks of taking this drug regularly until you get the full benefit.
If you are taking this drug "as needed" (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.
If your condition lasts or gets worse, or if you think you may have a serious medical problem, get medical help right away. If you are using the nonprescription product to treat fever, consult the doctor right away if the fever worsens or lasts more than 3 days.
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Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015 RECOMMENDATIONS

  1. We recommend that sleep physicians prescribe oral appliances, rather than no therapy, for adult patients who request treatment of primary snoring (without obstructive sleep apnea). (STANDARD)
    我們建議睡眠醫生應為尋求治療原發性打鼾（無阻塞性睡眠呼吸暫停）的成年患者開口內裝置，而不是不進行治療。 (標準)

  2. When oral appliance therapy is prescribed by a sleep physician for an adult patient with obstructive sleep apnea, we suggest that a qualified dentist use a custom, titratable appliance over non-custom oral devices. (GUIDELINE)
    當睡眠醫生為患有阻塞性睡眠呼吸暫停的成年患者開具口內裝置治療時，我們建議合格的牙醫使用客製、可滴定的口內裝置而不是非客製的口腔裝置。 (指南)

  3. We recommend that sleep physicians consider prescription of oral appliances, rather than no treatment, for adult patients with obstructive sleep apnea who are intolerant of CPAP therapy or prefer alternate therapy. (STANDARD)
    我們建議睡眠醫生考慮為對無法接受陽壓呼吸器CPAP治療或偏好替代療法的阻塞性睡眠呼吸暫停的成年患者開具口內裝置治療OAT處方，而不是不進行治療。 (標準)

  4. We suggest that qualified dentists provide oversight— rather than no follow-up—of oral appliance therapy in adult patients with obstructive sleep apnea, to survey for dental-related side effects or occlusal changes and reduce their incidence. (GUIDELINE)
    建議合格的牙醫對阻塞性睡眠呼吸暫停的成年患者進行口內裝置治療的監督，不是不進行隨訪，以調查與牙齒相關的副作用或咬合變化，並降低其發生率。 (指南)

  5. We suggest that sleep physicians conduct follow-up sleep testing to improve or confirm treatment efficacy, rather than conduct follow-up without sleep testing, for patients fitted with oral appliances. (GUIDELINE)
    我們建議睡眠醫生對配備口內裝置的患者進行後續睡眠測試，以改善或確認治療效果，而不是在沒有睡眠測試的情況下進行隨訪。 (指南)

  6. We suggest that sleep physicians and qualified dentists instruct adult patients treated with oral appliances for obstructive sleep apnea to return for periodic office visits— as opposed to no follow-up—with a qualified dentist and a sleep physician. (GUIDELINE)
    建議睡眠醫生和合格的牙醫指示使用口內裝置治療阻塞性睡眠呼吸暫停的成年患者定期返回辦公室就診，不是與合格的牙醫和睡眠醫生進行不進行隨訪。 (指南)

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What is oral appliance therapy?

Oral appliance therapy is a treatment for snoring and sleep apnea. It involves wearing a removable oral appliance in your mouth when you sleep. The device fits much like a sports mouth guard or orthodontic retainer. 

口腔內裝置治療是打鼾和睡眠呼吸暫停的治療方法。 主要是睡覺時，在嘴裡戴一個可拆卸的口腔用具，裝置很像運動戴護口器或矯正牙齒後戴的維持器。

An oral appliance prevents your airway from collapsing by either holding the tongue or supporting the jaw in a forward position. You must be custom fitted for an oral appliance for it to work properly. Over-the-counter devices are not recommended as a treatment option for snoring or sleep apnea.

口腔內裝置主要是透過握住舌頭或支撐下頜向前姿勢來防止氣道塌陷。 您必須定製口腔用具才能正常工作。 不建議將一般非處方裝置作為打鼾或睡眠呼吸暫停的治療選擇。

The sleep team at an accredited sleep center will work with you to provide you with oral appliance therapy. First, a sleep doctor must diagnose you with sleep apnea using a sleep study or home sleep apnea test. Once you are diagnosed, a dentist can fit you with an oral appliance. Dentists that work with the sleep team have special education in treating sleep apnea. 

透過專業認證睡眠中心的睡眠中心團隊，將為您提供口腔器械治療。 首先，睡眠專科醫生必須使用睡眠研究或家庭睡眠呼吸暫停測試來診斷您患有睡眠呼吸暫停。 一旦你被診斷出來，睡眠團隊可以為你客製、安裝口腔裝置。

The most effective treatment for sleep apnea is CPAP therapy. Some patients prefer an oral appliance because it is small, portable and easy to use. Oral appliance therapy is most helpful in people with mild to moderate obstructive sleep apnea. 

睡眠呼吸暫停最有效的治療方法是配戴正壓呼吸器CPAP療法。 某些患者、比較傾向口腔內裝置，因為它小巧、便攜且易於使用。 口腔內裝置治療對輕度至中度阻塞性睡眠呼吸暫停患者最有幫助。

What are the types of oral appliances?

There are a variety of oral appliances that can treat sleep apnea. Devices may look different. Most fall into one of two types：
有各種口服器具可以治療睡眠呼吸暫停。 裝置可能看起來不同。 大多數屬於兩種型別之一
Mandibular repositioning devices – These oral appliances move your lower jaw forward and down slightly to keep your airway open while you sleep. These are the most widely used oral appliances.
下頜重新定位裝置——這些口腔器械將下頜稍微向前和向下移動，以在您睡覺時保持氣道開放。 這些是使用最廣泛的口腔用具。

Tongue retaining devices – These devices hold your tongue in place to keep your airway open.
舌頭固定裝置——這些裝置將舌頭固定到位，以保持氣道暢通。

What are the benefits of oral appliance therapy?

For mild to moderate sleep apnea, oral appliance therapy offers many of the same health benefits as CPAP. By treating your sleep apnea, you can reduce your risk for heart disease, stroke and diabetes. You will also improve your daytime alertness, concentration and emotional health.
對於輕度至中度睡眠呼吸暫停，口腔器械療法提供許多與CPAP相同的健康益處。 透過治療睡眠呼吸暫停，您可以降低患心臟病、中風和糖尿病的風險。 您還將提高白天的警覺性、注意力和情緒健康。

The additional benefits of oral appliance therapy include：
口腔器械治療的其他好處包括

Ease of use – Some patients prefer oral appliances because they can be easy to wear. For most patients it takes a few weeks to get used to sleeping with an oral appliance.
易用性——一些患者更喜歡口腔用具，因為它們很容易佩戴。 對於大多數患者來說，需要幾周時間才能習慣用口腔器械睡覺。

Small and easy to transport – Traveling with your sleep apnea treatment is easy with an oral appliance. Unlike CPAP, oral appliances are small enough to fit in your purse or carry-on bag.
小巧且易於運輸——使用口腔器械輕鬆進行睡眠呼吸暫停治療。 與CPAP不同，口腔用具足夠小，可以放入您的錢包或手提包。

What are possible side effects of oral appliance therapy?

Oral appliance therapy may cause frequent but minor side effects. These include:

Excessive salivation
Dry mouth
Tooth and jaw discomfort
Temporary bite changes
  • 口腔器械治療可能會引起頻繁但輕微的副作用。 這些包括：
    唾液分泌過多
    口乾
    牙齒和下巴不適
    暫時的咬合變化

Some patients experience potential complications such as:

  • Jaw pain
  • Permanent changes to your bite
  • TMJ symptoms
  • 一些患者會出現潛在的併發症，例如：
    下巴疼痛
    永久改變你的咬合
    颞下颌關節炎症狀

These complications can be managed by the sleep team. Your dentist will work closely with your sleep doctor to make sure that your sleep apnea is well treated. This may involve a follow-up sleep test to make sure the oral appliance has been adjusted correctly and is effectively treating your sleep apnea.

這些併發症可以由睡眠團隊來管理。 您的牙醫將與您的睡眠醫生密切合作，以確保您的睡眠呼吸暫停得到良好治療。 這可能涉及後續睡眠測試，以確保口腔器械已正確調整，並有效治療睡眠呼吸暫停。

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If you are treating a chronic condition such as arthritis, ask your doctor about non-drug treatments and/or using other medications to treat your pain.
Image
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Check the ingredients on the label even if you have used the product before. The manufacturer may have changed the ingredients. Also, products with similar names may contain different ingredients meant for different purposes. Taking the wrong product could harm you.
How to use Naproxen Sodium
If you are taking the over-the-counter product, read all directions on the product package before taking this medication. If your doctor has prescribed this medication, read the Medication Guide provided by your pharmacist before you start taking naproxen and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Image
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Take this medication by mouth as directed by your doctor, usually 2 or 3 times a day with a full glass of water (8 ounces/240 milliliters). Do not lie down for at least 10 minutes after taking this drug. To prevent stomach upset, take this medication with food, milk, or an antacid.
For certain conditions (such as arthritis), it may take up to two weeks of taking this drug regularly until you get the full benefit.
If you are taking this drug "as needed" (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.
If your condition lasts or gets worse, or if you think you may have a serious medical problem, get medical help right away. If you are using the nonprescription product to treat fever, consult the doctor right away if the fever worsens or lasts more than 3 days.

打呼．鼻塞．睡眠障礙

專注於...
1. 困擾打呼（配偶埋怨）＋/ - 鼻塞(願意接受鼻子簡單手術) 。(MADs ＋/ - RF)
2. 呼吸中止不願配戴正壓呼吸器（願意接受鼻子簡單手術) 。(MADs ＋/ - RF)
3. 睡眠障礙想介入物理性療法。（EECP, rMTS,Thermal therapy)

4.整合正壓呼吸器．資源（resmed,resporonic..)
5.體重管理（ozempic Saxenda)
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三總睡眠中心．口腔裝置說明
呼吸道矯正原理

持續氣道正壓通氣(Continuous positive airway pressure, CPAP)是治療的黃金標準，但其療效受到依從性差和不耐受的限制。雖然口腔裝置矯正器(OA)在降低呼吸暫停低通氣指數(AHI)方面不如CPAP治療有效，但對不能忍受CPAP治療的輕度至中度OSA患者，口內裝置提供了另一種選擇。

一、口腔裝置在睡眠呼吸中止的應用
    口腔矯正器(OA)旨在改善上呼吸道的結構，並通過改變頜骨和  舌頭的位置來防止塌陷。最常見的作用機制是將下頜保持在一個更前的位置(OAm, mandibular advancement oral appliance)。影像學研究表明，使用OAm的下頜骨前移會擴大上氣道空間，最明顯的是在腭咽區域的側面。氣道空間的側向擴張可能是通過外側壁和下頜骨支之間的直接組織連接來介導的側向組織運動。不同程度的前舌運動也會發生在下頜前突，保持舌頭向前，防止它塌陷進氣道。

目前美國睡眠醫學會(AASM)建議，OAm作為輕度至中度阻塞性睡眠呼吸暫停(OSA)患者的第一線治療，以及CPAP治療失敗、較嚴重阻塞性睡眠呼吸暫停患者的第一線治療。

OAm並非對所有患者都有效，約有三分之一的患者沒有治療效果。OAm的耐受性一般良好，短期的不良反應在適應過程中是常見的。研究發現，夜間血氧的改善與下頜骨前移、擴大上氣道空間有關，用下頜骨前移．滴定法來確定隨時間逐漸增加、得到最佳前移被認為可優化治療結果。
2. 客製牙套原理與優勢，客製、定制化OAm設計，針對個案有效設計，提供：

(1) 導舌板的設計：舌頭保持組件專利設計，提供舌頭保持在向前向上的位置，促使舌頭往上往前伸，以防止它在睡眠期間塌陷到氣道中。
(2) 下顎骨前移：下頜前移組件將下頜（下頜骨）稍微向前重新定位，特殊、專業製程可配合臨床需求用滴定法來確定隨時間逐漸增加的最佳進展，打開呼吸道並減少阻塞、減少副作用的可能性。
(3) 提升口腔垂直高度：增加上下頜之間的垂直尺寸，有助於打開呼吸道並降低睡眠時阻塞風險。
(4) 特殊製程，為目前質地最軟的個人化、多功能客製口內裝置。
(5) 擁有具多國專利，包含台灣、中國、美國、歐盟專利。
(6) 避免口呼吸：研究顯示，口呼吸是造成呼吸道阻塞的主要原因，順利佩戴客製牙套後，可避免因口呼吸造成的呼吸道塌陷。

二、介入工具 呼吸道矯正療法

一般對患有打鼾或睡眠呼吸中止的處理，分別有手術、止鼾牙套或是正壓呼吸器，這些方法的著重在症狀上處理。手術有復發的問題，止鼾牙套是利用物理原理將下顎前移，正壓呼吸器作用原理為透過內建空氣馬達提供正壓力氣流經面罩進入呼吸道，使呼吸道在睡眠期間維持通暢。這些方法各有優點，同時也存在一些副作用。

目前的研究顯示，呼吸道內軟組織腫大與口呼吸有關連，也就是說患有口呼吸的人舌頭腫大是很重要的特徵，這也是打鼾與睡呼吸中止的人共同的問題，透過耳鼻喉科內視鏡、DISE、牙科CBCT可以測量出呼吸道阻塞的部位和氣道的大小，以來診斷睡眠呼吸障礙患者的問題。

大多數 OMD 起源於鼻呼吸不足、肌肉和口面部功能適應紊亂的呼吸模式。另外睡眠期間氣道塌陷的人也會經常改變身體位置或頭部姿勢，或者舌頭、下顎的位置來呼吸。

(1) 個人化、客製、可調式口內裝置Oral Appliance（Mandibular Advancement Devices)
(2) 客製硬顎擴骨：Cleveland Clinic ( Maxilla Expander )

三、評估、檢驗、檢查
睡眠問卷、ENT scope, Rhinomanometry, PSG, IgE, Biochemistry, Heart,  Lung, Liver, renal function evaluation, Cephalometry, CBCT ( 新創 ）

四、市場價格參考與核價、定價
(1) 建議 6萬起，titrate 3套（1.2萬*3)
(2) 手術費另計
(3) 其他費用：討論。

五、經驗分享：會提供相關成功案例與治療經驗作為醫師解釋、說明材料。
(1) 手術經驗（ＲＦ）：明成海....
(2) 陽光．ＭADs 經驗：黃志明、劉財源、林宗生...
(3) ＣPAP 經驗：好眠轉介

六、 執行．建議
(1) 客製牙套需要取個人石膏牙模，建議排定檢查後、排除手術必要性、使用購買正壓呼吸器，徵詢佩戴牙套意願後，先直接轉、會診至2、4週陳醫師睡眠門診（會配備取牙模材料、工具），待牙套製作好（需要3-4週）、配戴順利後，再轉回原看診醫師門診追蹤。
(2) 門診績效歸原看診醫師。
(3) 待流程順利後，就不需轉診。  

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Uses
Naproxen is used to relieve pain from various conditions such as headache, muscle aches, tendonitis, dental pain, and menstrual cramps. It also reduces pain, swelling, and joint stiffness caused by arthritis, bursitis, and gout attacks. This medication is known as a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking your body's production of certain natural substances that cause inflammation.
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If you are treating a chronic condition such as arthritis, ask your doctor about non-drug treatments and/or using other medications to treat your pain.
Check the ingredients on the label even if you have used the product before. The manufacturer may have changed the ingredients. Also, products with similar names may contain different ingredients meant for different purposes. Taking the wrong product could harm you.
How to use Naproxen Sodium
If you are taking the over-the-counter product, read all directions on the product package before taking this medication. If your doctor has prescribed this medication, read the Medication Guide provided by your pharmacist before you start taking naproxen and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth as directed by your doctor, usually 2 or 3 times a day with a full glass of water (8 ounces/240 milliliters). Do not lie down for at least 10 minutes after taking this drug. To prevent stomach upset, take this medication with food, milk, or an antacid.
For certain conditions (such as arthritis), it may take up to two weeks of taking this drug regularly until you get the full benefit.
If you are taking this drug "as needed" (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.
If your condition lasts or gets worse, or if you think you may have a serious medical problem, get medical help right away. If you are using the nonprescription product to treat fever, consult the doctor right away if the fever worsens or lasts more than 3 days.

居家睡眠檢測．Home Sleep Apnea Test．HSAT

在自己家裡，檢測
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錐狀射束電腦斷層影像．Cone Beam CT

目前普遍用於口腔診斷。其原理是X射線發生器以較低射線量圍繞投照體做環形數字式投照。就定位後，只要12秒即可輕鬆完成檢查，同範圍的輻射褲露量只有傳統頭部電腦斷層的5%~10 %

鼻阻壓力檢測．Rhinomanometry

檢查內容

可檢測患者的鼻腔容積及鼻腔內空氣的流速，計算出鼻腔內的阻力值，提供更客觀的鼻塞數據。

適合對象：檢視是否下鼻甲肥大，鼻中隔彎曲、鼻部外傷鼻竇炎、過敏性鼻炎引起的鼻塞。

檢測流程

  1. 請受檢者自行掛號，至門診接受醫師診斷，開立檢查單，至睡眠中心安排檢查時間。
  2. 檢測當天，依照檢查單上的時間至睡眠中心報到，須帶健保卡、檢查單。
  3. 檢查可預約時間： 星期一至星期五10:00 ~16:30。
  4. 檢查時間：約15-30分鐘。當日檢查後看診則需60分鐘。
  5. 檢測結束後，請自行回門診看報告。

注意事項

  1. 第一次到院檢查，攜帶健保卡、檢查單，檢查當天請直接至睡眠中心接受檢查。
  2. 受檢者請打電話預約檢查時間，不接受非預約時間檢查。
  3. 如需更改日期，請聯絡技師。
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自律．神經檢測

自律神經分為交感神經和副交感神經，交感神經使人體心跳加速、血壓上升、呼吸變快、腸胃蠕動變慢等，副交感神經則相反，交感、副交感神經互相協調以平衡來協調我們的器官運作。

一般所謂「自律神經檢查」，即「心律變異分析」(Heart Rate Variability, HRV)，是以非侵入式的方法以非侵入式的蒐集身體心電的訊號，經過訊號處理，分析出自律神經的各種指數，來檢測受測者自律神經的活性，包括交感、副交感活性、壓力指數、心律變異性等等，研究發現，自律神經功能與認知功能、身體健康狀況、心情、心血管風險等等都有關，透過客觀的自律神經檢測，可以了解自身目前的自律神經平衡狀態。
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EECP體外加強搏衝治療系統．Enhanced External Counter Pulsation

ECP是利用非侵入性機械輔助循環裝置，提高主動脈舒張壓，減低主動脈收縮壓，增加冠狀動脈血流，促進血管側枝循環形成的治療方式。美國及歐洲心臟學會對心血管疾病和心臟衰竭相關治療指引中已建議在符合相關適應症的患者身上使用EECP，為冠心病及心臟衰竭病患除手術及心導管外另一項選擇

治療方式

在人體下肢和臀部裹以特製的氣囊套，以心電圖Ｒ波為觸發信號，在心臟舒張早期，氣囊由遠至近加壓，驅動下肢血液向主動脈返流，提高主動脈舒張壓，從而改善心臟、大腦等重要器官的血液供應；在心臟收縮期前，氣囊迅速排氣，受壓的肢體血管開放，使主動脈收縮壓下降，從而減少外週循環阻力，減輕心臟負荷。EECP整個療程無須住院，為門診治療，共需要治療35個小時，每天1小時，每週5天，連續7週

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重覆經顱磁刺激(rTMS)

重覆經顱磁刺激(rTMS)已經於2018年經過台灣衛生福利部核可用來治療難治型憂鬱症患者，所謂難治型憂鬱症乃指患者經過兩個足夠劑量及足夠時間的抗憂鬱藥物治療，仍然無法得到預期的療效。過去此類患者需要伴隨其他治療，例如電痙攣治療（ECT），然而電痙攣治療侵入性較大，也會產生比較多的副作用。

重覆經顱磁刺激是透過磁場在腦部誘發出微電流刺激，使得情緒相關的大腦區域血流量增加及調控情緒迴路活性，進而產生治療效果，其好處是非侵入性且不需麻醉，除了某些患者(例如腦部有金屬植入物，癲癇及腦傷病史等)不適合使用外，是一項安全穩定的治療選擇。

重覆經顱磁刺激(rTMS)每次治療建議時間約20-40分鐘，每天一次，持續至少兩週，共十次刺激。療程時間及次數可以患者反應而做改變。另外，近來經顱磁刺激有發展加速型治療，稱高速經顱磁刺激治療(theta-burst stimulation)，這個治療模式能大幅減少刺激的時間，減少患者不適感，整體也可以達到和重覆經顱磁刺激(rTMS)相同之療效，能有效改善憂鬱症症狀。目前重覆經顱磁刺激(rTMS)治療屬於自費項目，尚未納入健保給付。

高雄榮民總醫院精神部已設置重複經顱磁刺激術（rTMS）之治療環境及團隊，希望提升整體醫療臨床服務，也期待可以提供難治型憂鬱症患者更多安全，理想的治療選擇。

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熱療．Thermal Therapy

IRATHERM較為精準的說法是熱療機，用較為高熱的方式提高局部溫度，但因為會產生熱效應，所以能做的時間約15-20分鐘，最多不超過30分鐘，因照射時間短，所以無法真正提升核心溫度，而這類設備的最大價值就是提升體溫，所以效果會有折扣。

SmartMotion則定義是光療機，但常被誤解為是熱療，因為經過照射後會提升核心溫度，進而排皮脂腺汗液，但實際上艙體內部溫度只有33-34度，主要是透過光能量進入細胞內粒線體去激活而提升核心溫度，本質上有差異。

IRATHERM設備是由Dr. Von Arden跟 Dr. Trogisch設計的，但Dr. Trogisch發現熱應力問題及其他可改善的部分，所以請韓國團隊研發新的Dr. Onko設備，用在光州醫院，主要做癌症術後治療。而後再到臺灣由我們大幅度優化整體架構，研發這台最新的SmartMotion設備，目前韓國的設備已全面將他們的燈模組更換成SmartMotion設備。
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If you are taking this drug "as needed" (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.
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相關．文獻

1. The effect of nasal and oral breathing on airway collapsibility in patients with obstructive sleep apnea: Computational fluid dynamics analyses
鼻呼吸和口呼吸對阻塞性睡眠呼吸中止症患者氣道塌陷的影響：計算流體力學分析

Computational fluid dynamics results during nasal and oral breathing revealed that oral breathing is the primary condition leading to pharyngeal airway collapse based on the concept of the Starling Resistor model. Airflow throughout the entirety of the breathing route was smoother during nasal breathing with closed mouth than that with open mouth.

If you are treating a chronic condition such as arthritis, ask your doctor about non-drug treatments and/or using other medications to treat your pain.
Check the ingredients on the label even if you have used the product before. The manufacturer may have changed the ingredients. Also, products with similar names may contain different ingredients meant for different purposes. Taking the wrong product could harm you.
Do Mandibular Advancement Devices Influence Patients' Snoring and Obstructive Sleep Apnea? A Cone-Beam Computed Tomography Analysis of the Upper Airway Volume

下顎前移裝置會影響患者的打鼾和阻塞性睡眠呼吸中止症嗎？ 上氣道容積的錐形束電腦斷層掃描分析

Purpose 
The upper airway volume is central to the development and treatment of snoring and obstructive sleep apnea, and mandibular advancement devices (MADs) have increasingly been used as an effective alternative to continuous positive airway pressure for these 2 conditions. We investigated the changes in breathing patterns and upper airway volume parameters measured on cone-beam computed tomography (CBCT) scans of patients with and without the use of custom-made MADs.
Materials and Methods
We performed a prospective study at the Department of Oral and Maxillofacial Surgery, Odense University Hospital, on consecutively treated patients. CBCT scans were performed with and without the MAD to measure the changes in the upper airway volume. The patients underwent diagnostic cardiorespiratory monitoring before and after 3 months of MAD therapy. Measurements with and without MAD were compared using Student's t test and the Wilcoxon signed rank test, and mixed-model analyses were performed adjusting for sleep apnea severity, type 2 diabetes, body mass index, gender, and age.
Results
A total of 44 patients (31 men and 13 women, age 50 ± 13 years, body mass index 31 ± 5.6 kg/m2) completed the trial. MAD therapy was associated with an increase in the total upper airway volume from 22.9 ± 8.7 cm3 before treatment to 26.7 ± 10.7 cm3 after treatment (P < .001). MAD therapy reduced the apnea-hypopnea index (AHI) from 15.8 ± 17.4 events/hour before treatment to 6.2 ± 9.8 events/hour after treatment (P < .001).
Conclusion
The results of the present study indicate that MAD therapy appears to produce significant changes in the upper airway volume that correlate with a decrease in the AHI.
研究結果：MAD治療會導致上呼吸道容積發生顯著變化，這與 AHI 降低有關。

Background

The effect of rapid maxillary expansion (RME) on the upper airway (UA) has been studied earlier but without a consistent conclusion. This study aims to evaluate the outcome of RME on the UA function in terms of aerodynamic characteristics by applying a computational fluid dynamics (CFD) simulation.

Methods

This retrospective cohort study consists of seventeen cases with two consecutive CBCT scans obtained before (T0) and after (T1) RME. Patients were divided into two groups with respect to patency of the nasopharyngeal airway as expressed in the adenoidal nasopharyngeal ratio (AN): group 1 was comprised of patients with an AN ratio < 0.6 and group 2 encompassing those with an AN ratio ≥ 0.6. CFD simulation at inspiration and expiration were performed based on the three-dimensional (3D) models of the UA segmented from the CBCT images. The aerodynamic characteristics in terms of pressure drop (ΔP), maximum midsagittal velocity (Vms), and maximum wall shear stress (Pws) were compared by paired t-test and Wilcoxon test according to the normality test at T0 and T1.

Results

The aerodynamic characteristics in UA revealed no statistically significant difference after RME. The maximum Vms (m/s) decreased from 2.79 to 2.28 at expiration after RME (P = 0.057).

Conclusion

The aerodynamic characteristics were not significantly changed after RME. Further CFD studies with more cases are warranted.

The effect of rapid maxillary expansion on the upper airway’s aerodynamic characteristics

If you are taking this drug "as needed" (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.
If your condition lasts or gets worse, or if you think you may have a serious medical problem, get medical help right away. If you are using the nonprescription product to treat fever, consult the doctor right away if the fever worsens or lasts more than 3 days.
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打鼾．評估．管理
打鼾可能是無害的（主要）或睡眠呼吸紊亂的症狀（次要），應提醒醫生評估患者的風險。 打鼾和睡眠呼吸紊亂（SDB）的表型是解剖學和非解剖學的，識別這些表型及其相互關係對有效治療至關重要。 口腔呼吸提醒醫生鼻氣道阻塞，預示兒童或面部生長變化，並預示著SDB的進展。 建立表型的系統評估包括評估睡眠習慣、合併症、上呼吸道檢查、多睡眠攝影和藥物誘導的睡眠內窺鏡檢查。 治療策略應針對表型進行個性化和精確化，以實現最大效益。
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If you are treating a chronic condition such as arthritis, ask your doctor about non-drug treatments and/or using other medications to treat your pain.
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Check the ingredients on the label even if you have used the product before. The manufacturer may have changed the ingredients. Also, products with similar names may contain different ingredients meant for different purposes. Taking the wrong product could harm you.
How to use Naproxen Sodium
If you are taking the over-the-counter product, read all directions on the product package before taking this medication. If your doctor has prescribed this medication, read the Medication Guide provided by your pharmacist before you start taking naproxen and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
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Take this medication by mouth as directed by your doctor, usually 2 or 3 times a day with a full glass of water (8 ounces/240 milliliters). Do not lie down for at least 10 minutes after taking this drug. To prevent stomach upset, take this medication with food, milk, or an antacid.
For certain conditions (such as arthritis), it may take up to two weeks of taking this drug regularly until you get the full benefit.
If you are taking this drug "as needed" (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.
If your condition lasts or gets worse, or if you think you may have a serious medical problem, get medical help right away. If you are using the nonprescription product to treat fever, consult the doctor right away if the fever worsens or lasts more than 3 days.
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Uses
Naproxen is used to relieve pain from various conditions such as headache, muscle aches, tendonitis, dental pain, and menstrual cramps. It also reduces pain, swelling, and joint stiffness caused by arthritis, bursitis, and gout attacks. This medication is known as a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking your body's production of certain natural substances that cause inflammation.
If you are treating a chronic condition such as arthritis, ask your doctor about non-drug treatments and/or using other medications to treat your pain.
Image
Check the ingredients on the label even if you have used the product before. The manufacturer may have changed the ingredients. Also, products with similar names may contain different ingredients meant for different purposes. Taking the wrong product could harm you.
How to use Naproxen Sodium
If you are taking the over-the-counter product, read all directions on the product package before taking this medication. If your doctor has prescribed this medication, read the Medication Guide provided by your pharmacist before you start taking naproxen and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
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Take this medication by mouth as directed by your doctor, usually 2 or 3 times a day with a full glass of water (8 ounces/240 milliliters). Do not lie down for at least 10 minutes after taking this drug. To prevent stomach upset, take this medication with food, milk, or an antacid.
For certain conditions (such as arthritis), it may take up to two weeks of taking this drug regularly until you get the full benefit.
If you are taking this drug "as needed" (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.
If your condition lasts or gets worse, or if you think you may have a serious medical problem, get medical help right away. If you are using the nonprescription product to treat fever, consult the doctor right away if the fever worsens or lasts more than 3 days.
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Uses
  1. 客製牙套．定價：
  2. 找診間、人力
  3. 醫院簽約流程與相關文件
  4. 牙技所製作資格、技術
  5. 由合約公司交件
  6. 院內建「自費碼」
  7. 衛生局報備
  8. 睡眠中心醫師產品說明
  9. 臨床、分科研究、新創競賽並行
If you are treating a chronic condition such as arthritis, ask your doctor about non-drug treatments and/or using other medications to treat your pain.
Check the ingredients on the label even if you have used the product before. The manufacturer may have changed the ingredients. Also, products with similar names may contain different ingredients meant for different purposes. Taking the wrong product could harm you.
How to use Naproxen Sodium
If you are taking the over-the-counter product, read all directions on the product package before taking this medication. If your doctor has prescribed this medication, read the Medication Guide provided by your pharmacist before you start taking naproxen and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Image
Image
Take this medication by mouth as directed by your doctor, usually 2 or 3 times a day with a full glass of water (8 ounces/240 milliliters). Do not lie down for at least 10 minutes after taking this drug. To prevent stomach upset, take this medication with food, milk, or an antacid.
For certain conditions (such as arthritis), it may take up to two weeks of taking this drug regularly until you get the full benefit.
If you are taking this drug "as needed" (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.
If your condition lasts or gets worse, or if you think you may have a serious medical problem, get medical help right away. If you are using the nonprescription product to treat fever, consult the doctor right away if the fever worsens or lasts more than 3 days.
Image
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If you are treating a chronic condition such as arthritis, ask your doctor about non-drug treatments and/or using other medications to treat your pain.