Quinnell Timothy G, Smith Ian E
Respiratory Support and Sleep Centre, Papworth Hospital, Papworth Everard, Cambridge CB3 8RE, UK.
Drugs Aging. 2004;21(5):307-22. doi: 10.2165/00002512-200421050-00003.
Obstructive sleep apnoea is characterised by repetitive interruptions of breathing during sleep due to upper airway collapse. It affects sleep quality, daytime alertness and quality of life. It is associated with increased cardiovascular morbidity and mortality and an increased risk of road traffic accidents. Sleep apnoea is common among older people and its effects can be more severe than in younger people. The added impact is because of a physiological decline in sleep quality with age in most people and the increasing frequency of other comorbidities with increasing years that affect both sleep and daytime function. It is important to be alert to the diagnosis, bearing in mind these other influences on sleep quality. The diagnosis is generally straightforward once appropriate tests are performed. Treatment is aimed at minimising upper airway obstruction during sleep and the most effective therapy is continuous positive airway pressure. Weight loss can also be effective. Other management options, including surgery, mandibular advancement devices and drug treatment, are less effective, but there are interesting advances in the understanding of the pharmacology of the upper airway. Specific serotonergic agonists hold the greatest potential for a useful drug treatment for this widespread and debilitating condition.
阻塞性睡眠呼吸暂停的特征是睡眠期间由于上气道塌陷导致呼吸反复中断。它会影响睡眠质量、日间警觉性和生活质量。它与心血管疾病发病率和死亡率增加以及道路交通事故风险增加有关。睡眠呼吸暂停在老年人中很常见，其影响可能比年轻人更严重。这种额外的影响是由于大多数人随着年龄增长睡眠质量出现生理性下降，以及随着年龄增长其他合并症的发生率增加，这些合并症会影响睡眠和日间功能。考虑到这些对睡眠质量的其他影响，警惕诊断很重要。一旦进行了适当的检查，诊断通常很简单。治疗旨在尽量减少睡眠期间的上气道阻塞，最有效的治疗方法是持续气道正压通气。减肥也可能有效。其他治疗选择，包括手术、下颌前移装置和药物治疗，效果较差，但在上气道药理学的认识方面有一些有趣的进展。特定的血清素能激动剂在治疗这种广泛且使人衰弱的疾病方面最有潜力成为有效的药物治疗方法。
