University of Melbourne, Melbourne, VIC, Australia; Institute for Breathing and Sleep, Melbourne, VIC, Australia.
Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Letterkenny General Hospital, County Donegal, Ireland.
Lancet. 2014 Feb 22;383(9918):736-47. doi: 10.1016/S0140-6736(13)60734-5. Epub 2013 Aug 2.
Obstructive sleep apnoea is an increasingly common disorder of repeated upper airway collapse during sleep, leading to oxygen desaturation and disrupted sleep. Features include snoring, witnessed apnoeas, and sleepiness. Pathogenesis varies; predisposing factors include small upper airway lumen, unstable respiratory control, low arousal threshold, small lung volume, and dysfunctional upper airway dilator muscles. Risk factors include obesity, male sex, age, menopause, fluid retention, adenotonsillar hypertrophy, and smoking. Obstructive sleep apnoea causes sleepiness, road traffic accidents, and probably systemic hypertension. It has also been linked to myocardial infarction, congestive heart failure, stroke, and diabetes mellitus though not definitively. Continuous positive airway pressure is the treatment of choice, with adherence of 60-70%. Bi-level positive airway pressure or adaptive servo-ventilation can be used for patients who are intolerant to continuous positive airway pressure. Other treatments include dental devices, surgery, and weight loss.
阻塞性睡眠呼吸暂停是一种日益常见的睡眠中反复发生上气道塌陷的疾病，导致氧饱和度降低和睡眠中断。其特征包括打鼾、目击呼吸暂停和嗜睡。发病机制各异；易患因素包括小的上气道腔、不稳定的呼吸控制、低觉醒阈值、小肺容量和功能障碍的上气道扩张肌。危险因素包括肥胖、男性、年龄、绝经、体液潴留、腺样体扁桃体肥大和吸烟。阻塞性睡眠呼吸暂停会导致嗜睡、道路交通事故，可能还会导致全身性高血压。它还与心肌梗死、充血性心力衰竭、中风和糖尿病有关，但尚未明确。持续气道正压通气是首选治疗方法，其依从性为 60-70%。双水平气道正压通气或适应性伺服通气可用于不能耐受持续气道正压通气的患者。其他治疗方法包括牙科设备、手术和减肥。
