Henderson J H, Strollo P J
Uniformed Services University of the Health Sciences, Wilford Hall Medical Center, Lackland AFB, TX, USA.
Prog Cardiovasc Dis. 1999 Mar-Apr;41(5):377-86. doi: 10.1053/pcad.1999.0410377.
The last 20 years have seen remarkable gains in our understanding of the pathophysiology of sleep-disordered breathing. The rapid growth in both scientific and clinical knowledge has been fueled by the development of nonsurgical therapies for obstructive sleep apnea (OSA). These medical therapies have provided the avenue for public acceptance of the diagnosis and treatment of this common medical condition. However, medical therapy requires active patient participation, to achieve the desired outcomes of improved sleep continuity, daytime functioning, and quality of life. Conservative therapies, such as weight loss and patient positioning; and pharmacological therapies, have been disappointing. Positive pressure therapy has become the treatment of choice for the vast majority of OSA patients. Oral appliances offer an acceptable treatment alternative for select patients. Present research indicates that these mechanical approaches can produce significant decreases in the frequency and severity of sleep-disordered breathing and nocturnal oxyhemoglobin desaturation. Preliminary data from ongoing studies suggest that these interventions will reduce long-term morbidity and possibly mortality.
在过去20年里，我们对睡眠呼吸障碍病理生理学的理解取得了显著进展。阻塞性睡眠呼吸暂停（OSA）非手术治疗方法的发展推动了科学和临床知识的迅速增长。这些医学疗法为公众接受这种常见病症的诊断和治疗提供了途径。然而，医学治疗需要患者积极参与，以实现改善睡眠连续性、日间功能和生活质量的预期效果。诸如减肥和患者体位调整等保守疗法，以及药物疗法，效果都不尽人意。正压通气治疗已成为绝大多数OSA患者的首选治疗方法。口腔矫治器为部分患者提供了可接受的治疗选择。目前的研究表明，这些机械方法可显著降低睡眠呼吸障碍的频率和严重程度以及夜间氧合血红蛋白饱和度下降情况。正在进行的研究的初步数据表明，这些干预措施将降低长期发病率，并可能降低死亡率。
