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阻塞性睡眠呼吸暂停的个性化治疗策略

Tailored treatment strategies for obstructive sleep apnea.

作者信息

Shin Wonchul, Jen Rachel, Li Yanru, Malhotra Atul

机构信息

Department of Neurology, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.

Respiratory Division, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.

出版信息

Respir Investig. 2016 Jan;54(1):2-7. doi: 10.1016/j.resinv.2015.09.007. Epub 2015 Dec 8.

Abstract

Obstructive sleep apnea (OSA) is characterized by repetitive collapse of the upper airway (UA) during sleep and is associated with chronic intermittent hypoxemia, catecholamine surges, and sleep disrupt. Multiple pathophysiological risk factors have been identified and contribute to OSA, including anatomical abnormalities (elevated UA mechanical load), compromised UA dilators, increased loop gain (unstable respiratory control), and decreased arousal threshold. These factors may contribute to the pathophysiology of sleep apnea in different individuals and recent evidence suggests that treatment may be targeted towards underlying pathophysiological mechanism. In some cases, combination therapy may be required to treat the condition.

摘要

阻塞性睡眠呼吸暂停(OSA)的特征是睡眠期间上气道(UA)反复塌陷,并与慢性间歇性低氧血症、儿茶酚胺激增和睡眠中断有关。已经确定了多种病理生理风险因素并促成了OSA,包括解剖学异常(上气道机械负荷增加)、上气道扩张肌受损、环路增益增加(呼吸控制不稳定)和唤醒阈值降低。这些因素可能在不同个体中促成睡眠呼吸暂停的病理生理过程,最近的证据表明治疗可能针对潜在的病理生理机制。在某些情况下,可能需要联合治疗来治疗该病症。

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