Qureshi Asher, Ballard Robert D
Sleep Medicine Section, Department of Medicine, National Jewish Medical and Research Center, University of Colorado Health Sciences Center, Denver, CO 80206, USA.
J Allergy Clin Immunol. 2003 Oct;112(4):643-51; quiz 652. doi: 10.1016/j.jaci.2003.08.031.
Obstructive sleep apnea is an increasingly well-recognized disease characterized by periodic collapse of the upper airway during sleep. This leads to either complete or partial obstruction of the airway, resulting in apneas, hypopneas, or both. This disorder causes daytime somnolence, neurocognitive defects, and depression. It affects almost every system in the body, resulting in an increased incidence of hypertension, cardiovascular disease, stroke, pulmonary hypertension, cardiac arrhythmias, and altered immune function. It also increases the risk of having an accident, presumably as a result of associated somnolence. The gold standard for the diagnosis of sleep apnea is an overnight polysomnogram. Split-night studies are becoming increasingly common and allow for quicker implementation of therapy at a reduced cost. Treatment options for sleep apnea include weight loss, positional therapy, oral devices, continuous positive airway pressure (CPAP), and upper airway surgery. CPAP is the most efficacious and widely used therapy. Its complications include nasal congestion or dryness, mask discomfort, and claustrophobia. Heated humidifiers, newer types of masks, and nasal steroids have improved tolerance of this therapy. Bilevel positive-pressure therapy can be considered for patients who find it difficult to exhale against the consistently increased pressure of CPAP. The disease requires aggressive treatment to improve quality of life and prevent its complications.
阻塞性睡眠呼吸暂停是一种日益被广泛认识的疾病，其特征是睡眠期间上气道周期性塌陷。这会导致气道完全或部分阻塞，从而引发呼吸暂停、呼吸不足或两者皆有。这种疾病会导致日间嗜睡、神经认知缺陷和抑郁。它几乎影响身体的每个系统，导致高血压、心血管疾病、中风、肺动脉高压、心律失常以及免疫功能改变的发病率增加。它还会增加发生事故的风险，可能是由于相关的嗜睡所致。睡眠呼吸暂停诊断的金标准是夜间多导睡眠图。分夜研究越来越普遍，并且能够以更低的成本更快地实施治疗。睡眠呼吸暂停的治疗选择包括减肥、体位治疗、口腔矫治器、持续气道正压通气（CPAP）和上气道手术。CPAP是最有效且应用最广泛的治疗方法。其并发症包括鼻塞或干燥、面罩不适和幽闭恐惧症。加热加湿器、新型面罩和鼻用类固醇已提高了对这种治疗的耐受性。对于那些发现难以对抗CPAP持续增加的压力呼气的患者，可以考虑采用双水平正压通气治疗。该疾病需要积极治疗以改善生活质量并预防其并发症。
