Kaplan J, Staats B A
Division of Thoracic Diseases and Internal Medicine, Mayo Clinic Jacksonville, Florida.
Mayo Clin Proc. 1990 Aug;65(8):1087-94. doi: 10.1016/s0025-6196(12)62721-9.
Obstructive sleep apnea syndrome is the most common cause of hypersomnolence in patients referred to sleep disorders centers. This type of sleep apnea is characterized by loud snoring, nocturnal oxyhemoglobin desaturation, and disrupted sleep that leads to daytime hypersomnolence. The anatomic configuration of the pharynx and the physiologic responses to occlusion of the upper airway play a major role in the pathogenesis of this disorder. Polysomnography can accurately identify obstructive sleep apnea, and the multiple sleep latency test allows an objective measurement of daytime alertness. Weight loss and training the patient to sleep in a lateral position are frequently used to alleviate mild cases. Nasally applied continuous positive airway pressure is an extremely effective modality for treating moderate and severe obstructive sleep apnea. Surgical correction of obvious anatomic defects has a role in diminishing obstructive sleep apnea, but the exact role of surgical intervention in patients without obvious anatomic defects remains unknown. The choice of therapy should be tailored to the individual patient with sleep apnea, and careful follow-up is essential to ensure a positive response to therapy.
阻塞性睡眠呼吸暂停综合征是转诊至睡眠障碍中心的患者出现过度嗜睡的最常见原因。这种类型的睡眠呼吸暂停的特征是大声打鼾、夜间氧合血红蛋白饱和度降低以及睡眠中断，进而导致日间过度嗜睡。咽部的解剖结构以及对上气道阻塞的生理反应在该疾病的发病机制中起主要作用。多导睡眠图可以准确识别阻塞性睡眠呼吸暂停，多次睡眠潜伏期测试能够客观测量日间警觉性。减肥以及训练患者侧卧睡眠常用于缓解轻度病例。经鼻持续气道正压通气是治疗中度和重度阻塞性睡眠呼吸暂停的极其有效的方法。对明显解剖缺陷进行手术矫正对减轻阻塞性睡眠呼吸暂停有作用，但手术干预在无明显解剖缺陷患者中的确切作用尚不清楚。治疗方案的选择应根据睡眠呼吸暂停患者的个体情况量身定制，仔细随访对于确保治疗取得积极效果至关重要。
