Anttalainen Ulla, Tenhunen Mirja, Rimpilä Ville, Polo Olli, Rauhala Esa, Himanen Sari-Leena, Saaresranta Tarja
Division of Medicine, Department of Pulmonary Diseases, Turku University Hospital, Turku, Finland.
Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland.
Eur Clin Respir J. 2016 Sep 6;3:31806. doi: 10.3402/ecrj.v3.31806. eCollection 2016.
Obstructive sleep apnea syndrome (OSAS) is a well-recognized disorder conventionally diagnosed with an elevated apnea-hypopnea index. Prolonged partial upper airway obstruction is a common phenotype of sleep-disordered breathing (SDB), which however is still largely underreported. The major reasons for this are that cyclic breathing pattern coupled with arousals and arterial oxyhemoglobin saturation are easy to detect and considered more important than prolonged episodes of increased respiratory effort with increased levels of carbon dioxide in the absence of cycling breathing pattern and repetitive arousals. There is also a growing body of evidence that prolonged partial obstruction is a clinically significant form of SDB, which is associated with symptoms and co-morbidities which may partially differ from those associated with OSAS. Partial upper airway obstruction is most prevalent in women, and it is treatable with the nasal continuous positive pressure device with good adherence to therapy. This review describes the characteristics of prolonged partial upper airway obstruction during sleep in terms of diagnostics, pathophysiology, clinical presentation, and comorbidity to improve recognition of this phenotype and its timely and appropriate treatment.
阻塞性睡眠呼吸暂停综合征（OSAS）是一种公认的疾病，传统上通过升高的呼吸暂停低通气指数进行诊断。长时间的部分上气道阻塞是睡眠呼吸紊乱（SDB）的常见表现型，然而其报告率仍然很低。主要原因在于，与呼吸周期相关的呼吸模式以及觉醒和动脉血氧血红蛋白饱和度易于检测，并且被认为比在没有呼吸周期模式和重复性觉醒的情况下，伴有二氧化碳水平升高的长时间呼吸努力增加更为重要。也有越来越多的证据表明，长时间的部分阻塞是SDB的一种具有临床意义的形式，它与一些症状和合并症相关，这些症状和合并症可能与OSAS相关的部分有所不同。部分上气道阻塞在女性中最为普遍，使用鼻持续气道正压通气设备治疗效果良好，且患者对治疗的依从性较高。本综述从诊断、病理生理学、临床表现和合并症等方面描述了睡眠期间长时间部分上气道阻塞的特征，以提高对这种表现型的认识及其及时、恰当的治疗。
