Paiva Teresa, Attarian Hrayr
Sleep Medicine Centre, Medical Faculty of Lisbon, Lisbon, Portugal.
Circadian Rhythms and Sleep Research Laboratory, Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Handb Clin Neurol. 2014;119:251-71. doi: 10.1016/B978-0-7020-4086-3.00018-7.
Obstructive sleep apnea syndrome (OSAS) is a common disorder characterized by repetitive episodes of breathing cessation due to complete or partial collapse of the upper airway therefore affecting ventilation. It is quite common, with a prevalence of about 2-4%, has a strong genetic component, and creates a proinflammatory state with elevated TNFα and other cytokines. If untreated, OSA can lead to significant neurological problems that include stroke, cognitive decline, depression, headaches, peripheral neuropathy, and nonarteritic ischemic optic neuropathy (NAION). Treatment reverses some of these neurological problems. Treatment includes continuous positive airway pressure and its variants, oral appliances, weight loss, upper airway surgery, and rarely maxillofacial procedures. Other sleep breathing disorders such as hypoventilation, central sleep apnea, complex sleep apnea, and Cheyne-Stokes respiration are less common and are sometimes associated with neuromuscular disorders causing diaphragmatic paralysis, but can also be seen in opiate exposure and severe obesity.
阻塞性睡眠呼吸暂停综合征（OSAS）是一种常见疾病，其特征是由于上呼吸道完全或部分塌陷导致反复出现呼吸暂停，从而影响通气。它相当常见，患病率约为2%-4%，具有很强的遗传成分，并会产生以肿瘤坏死因子α（TNFα）和其他细胞因子升高为特征的促炎状态。如果不进行治疗，阻塞性睡眠呼吸暂停综合征可导致严重的神经问题，包括中风、认知能力下降、抑郁、头痛、周围神经病变和非动脉性缺血性视神经病变（NAION）。治疗可逆转其中一些神经问题。治疗方法包括持续气道正压通气及其变体、口腔矫治器、减肥、上呼吸道手术，很少采用颌面手术。其他睡眠呼吸障碍，如通气不足、中枢性睡眠呼吸暂停、复杂性睡眠呼吸暂停和潮式呼吸则不太常见，有时与导致膈肌麻痹的神经肌肉疾病有关，但也可见于阿片类药物暴露和重度肥胖患者。
