Sahlman Johanna, Pukkila Matti, Seppä Juha, Tuomilehto Henri
Department of Otorhinolaryngology, Kuopio University Hospital and University of Kuopio, Kuopio, Finland.
Laryngoscope. 2007 Jun;117(6):1107-11. doi: 10.1097/MLG.0b013e3180514d08.
To evaluate the prognosis of mild obstructive sleep apnea in relation to different treatment modalities.
An open, retrospective, longitudinal follow-up study.
Fifty adult patients diagnosed and treated for mild obstructive sleep apnea at the Department of Otorhinolaryngology at Kuopio University Hospital between 1998 and 2004 had a control polysomnography in 2005. The changes in apnea-hypopnea index (AHI) were observed in untreated (n = 28), operative (n = 11), and continuous positive airway pressure (n = 11) treatment groups at a long-term follow-up visit.
The mean follow-up period was 4 (range, 1.3-9.0; SD, 1.9) years. The untreated patients had a statistically significant increase in AHI (13.3, SD 18.3) at the follow-up. Half of these patients developed a moderate or severe degree of sleep apnea, and only 11% were cured. In patients who were treated with continuous positive airway pressure, the degree of obstructive sleep apnea became worse in 64% of cases, and in 27% of patients, the AHI returned to normal (<5). The degree of obstructive sleep apnea in operated patients deteriorated only in 18%, and in 27% of the patients, the AHI returned to normal (<5).
Mild obstructive sleep apnea has a natural tendency to worsen with time. Active treatment of mild obstructive sleep apnea appears, therefore, to be advisable.
评估轻度阻塞性睡眠呼吸暂停与不同治疗方式相关的预后情况。
一项开放性、回顾性纵向随访研究。
1998年至2004年期间在库奥皮奥大学医院耳鼻喉科被诊断并接受轻度阻塞性睡眠呼吸暂停治疗的50例成年患者于2005年进行了对照多导睡眠监测。在长期随访时观察了未治疗组（n = 28）、手术治疗组（n = 11）和持续气道正压通气治疗组（n = 11）的呼吸暂停低通气指数（AHI）变化。
平均随访期为4年（范围1.3 - 9.0年；标准差1.9年）。随访时，未治疗患者的AHI有统计学意义的升高（13.3，标准差18.3）。这些患者中有一半发展为中度或重度睡眠呼吸暂停，只有11%治愈。在接受持续气道正压通气治疗的患者中，64%的病例阻塞性睡眠呼吸暂停程度加重，27%的患者AHI恢复正常（<5）。手术治疗患者中阻塞性睡眠呼吸暂停程度仅18%恶化，27%的患者AHI恢复正常（<5）。
轻度阻塞性睡眠呼吸暂停有随时间自然加重的趋势。因此，对轻度阻塞性睡眠呼吸暂停进行积极治疗似乎是可取的。
