Sharma Hanish, Sharma S K
Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
Indian J Chest Dis Allied Sci. 2008 Jan-Mar;50(1):137-50.
Obstructive sleep apnoea (OSA) is a leading public health problem both in the developed and developing nations. However, awareness regarding diagnostic options, management and consequences of untreated OSA remains inadequate. In developing nations, the resources for adequate sleep medicine facilities are scarce. Therefore, there is a need for low cost, simple and accurate diagnostic and therapeutic modalities exists. Untreated OSA leads to excessive daytime sleepiness, diminished performance and an overall poor quality of life. The role of OSA in promoting insulin resistance, atherosclerosis, hypertension and a procoagulant state has now been established. Newer insights into the biochemical and genetic mediators of OSA have raised hopes regarding the development of a "cure". However, as of now, continuous positive airway pressure (CPAP) therapy remains the first-line treatment. Though its use improves the quality of life as well as metabolic derangements observed in OSA, patients' acceptance remains low. Its high cost and long-term use are also cumbersome. Newer modes of delivering CPAP, oral appliances and upper airway surgery are the other options available. It is hoped that their appropriate use to increase patients' compliance may improve the quality of life as well as provide a survival benefit.
阻塞性睡眠呼吸暂停（OSA）在发达国家和发展中国家都是一个主要的公共卫生问题。然而，对于OSA的诊断选择、管理以及未经治疗的后果的认识仍然不足。在发展中国家，用于充足睡眠医学设施的资源稀缺。因此，需要低成本、简单且准确的诊断和治疗方式。未经治疗的OSA会导致白天过度嗜睡、表现下降以及整体生活质量差。OSA在促进胰岛素抵抗、动脉粥样硬化、高血压和促凝状态方面的作用现已得到证实。对OSA的生化和遗传介质的新见解为“治愈”的发展带来了希望。然而，截至目前，持续气道正压通气（CPAP）治疗仍然是一线治疗方法。尽管其使用改善了OSA患者的生活质量以及代谢紊乱，但患者的接受度仍然很低。其高成本和长期使用也很麻烦。提供CPAP的新模式、口腔矫治器和上气道手术是其他可用的选择。希望它们的适当使用以提高患者的依从性可以改善生活质量并提供生存益处。
