Kimoff R J, Cosio M G, McGregor M
Department of Medicine, McGill University, Montreal, Que.
CMAJ. 1991 Mar 15;144(6):689-95.
To review the clinical features and treatment of obstructive sleep apnea (OSA).
All articles on OSA published in French and English between 1970 and 1990 and indexed in Index Medicus were reviewed. Studies addressing the epidemiologic features and clinical aspects of OSA were selected, and special emphasis was given to articles reporting the effects of treatment on morbidity and mortality rates.
OSA is characterized by episodes of upper airway obstruction during sleep that result in repetitive hypoxemia and sleep disruption. OSA leads to various neuropsychologic and cardiovascular complications, including daytime hypersomnolence, cognitive impairment, systemic and pulmonary hypertension and cardiac arrhythmias. There is suggestive evidence that the death rate among affected people is increased. The true incidence of OSA is unknown, but estimates have varied from 1% upwards among men. The current treatment with the greatest overall effectiveness and acceptability is nasal continuous positive airway pressure.
This common, readily treatable disorder is associated with serious complications and therefore must be widely recognized by health professionals.
回顾阻塞性睡眠呼吸暂停(OSA)的临床特征及治疗方法。
对1970年至1990年间发表在法语和英语期刊上且被《医学索引》收录的所有关于OSA的文章进行回顾。选取了涉及OSA流行病学特征和临床方面的研究,并特别强调了报道治疗对发病率和死亡率影响的文章。
OSA的特征是睡眠期间上呼吸道阻塞发作,导致反复低氧血症和睡眠中断。OSA会引发各种神经心理和心血管并发症,包括白天嗜睡、认知障碍、系统性和肺动脉高压以及心律失常。有提示性证据表明患者的死亡率有所增加。OSA的真实发病率尚不清楚,但男性的估计发病率从1%以上不等。目前总体效果最佳且最易接受的治疗方法是经鼻持续气道正压通气。
这种常见且易于治疗的疾病会引发严重并发症,因此必须得到卫生专业人员的广泛认可。