Weitzman E D, Pollack C P, Borowiecki B
Arch Neurol. 1978 Jun;35(6):392-5. doi: 10.1001/archneur.1978.00500300066013.
A 67-year-old woman with acquired micrognathia developed severe daytime hypersomnia, loud snoring, nocturnal enuresis, encopresis, and hypertension. A polysomnogram demonstrated 564 sleep apneas, primarily obstructive, recurrent hypoxia, a bradytachycardia, and absent stages III, IV, and REM sleep. Endoscopy during sleep revealed recurrent active closure of the upper pharynx associated with loud snoring. A tracheoplasty was done because of severity of symptoms and failure of conservative therapy. Dramatic improvement in sleepiness and hypertension occurred within 48 hours. On postoperative night 15 a repeated polysomnogram showed only 23 apneas, no hypoxia or bradytachycardia, and long periods of stage II, IV, and REM sleep. Patients with the hypersomnia-sleep apnea syndrome should be provided with a tracheal opening during sleep when severe daytime somnolence, cardiac arrhythmias, and hypertension are present.
一名67岁患有后天性小颌畸形的女性出现了严重的日间嗜睡、大声打鼾、夜间遗尿、大便失禁和高血压。多导睡眠图显示有564次睡眠呼吸暂停，主要为阻塞性，反复出现低氧血症、心动过缓-心动过速，且无Ⅲ期、Ⅳ期和快速眼动睡眠阶段。睡眠期间的内镜检查显示上咽部反复主动闭合并伴有大声打鼾。由于症状严重且保守治疗无效，遂进行了气管成形术。术后48小时内，嗜睡和高血压症状显著改善。术后第15个晚上，重复进行的多导睡眠图显示仅有23次呼吸暂停，无低氧血症或心动过缓-心动过速，且有长时间的Ⅱ期、Ⅳ期和快速眼动睡眠。对于患有嗜睡-睡眠呼吸暂停综合征且存在严重日间嗜睡、心律失常和高血压的患者，睡眠期间应进行气管造口。
