Prisant L Michael, Dillard Thomas A, Blanchard Amy R
Departments of Medicine, Medical College of Georgia, Augusta, GA 30912, USA.
J Clin Hypertens (Greenwich). 2006 Oct;8(10):746-50. doi: 10.1111/j.1524-6175.2006.888139.x.
Obstructive sleep apnea syndrome is caused by upper airway collapse during inspiration, causing intermittent hypoxemia, hypercapnia, acidosis, sympathetic nervous system activation, and arousal from sleep. Nighttime blood pressure is higher, but unexpectedly, daytime hypertension occurs. The prevalence of hypertension is very high and the incidence of hypertension increases as the number of apneic and hypopneic events per hour rises. Obesity is a major predisposing factor for the development of obstructive sleep apnea. Daytime sleepiness, snoring, and breathing pauses are important symptoms to elicit from the patient or sleep partner. Resistant hypertension is an important clue. Overnight polysomnography is required for diagnosis. Weight loss, avoidance of nocturnal sedatives, cessation of evening alcohol ingestion, and avoidance of the supine position during sleep are initial therapeutic actions in mild obstructive sleep apnea syndrome. Continuous positive airway pressure is the treatment of choice for patients unable to find relief from lifestyle changes. Blood pressure modestly improves with treatment.
阻塞性睡眠呼吸暂停综合征是由吸气时上呼吸道塌陷引起的，导致间歇性低氧血症、高碳酸血症、酸中毒、交感神经系统激活以及睡眠中觉醒。夜间血压较高，但出乎意料的是，会出现日间高血压。高血压的患病率非常高，并且随着每小时呼吸暂停和呼吸浅慢事件的数量增加，高血压的发病率也会上升。肥胖是阻塞性睡眠呼吸暂停发生的主要诱发因素。日间嗜睡、打鼾和呼吸暂停是需要向患者或睡眠伙伴询问的重要症状。顽固性高血压是一个重要线索。诊断需要进行夜间多导睡眠图检查。在轻度阻塞性睡眠呼吸暂停综合征中，初始治疗措施包括减重、避免夜间使用镇静剂、停止夜间饮酒以及睡眠时避免仰卧位。持续气道正压通气是无法通过生活方式改变获得缓解的患者的首选治疗方法。治疗后血压会适度改善。
