Burman Deepa
Latterman Family Health Center, 2347 Fifth Ave, McKeesport, PA 15132.
FP Essent. 2017 Sep;460:11-21.
Sleep-related breathing disorders or sleep-disordered breathing are characterized by abnormal respiration during sleep. They are grouped into obstructive sleep apnea (OSA), central sleep apnea, sleep-related hypoventilation, and sleep-related hypoxemia disorder. OSA is a common disorder encountered in the family medicine setting that is increasingly being recognized because of the obesity epidemic and greater public and physician awareness. OSA is characterized by recurrent episodes of partial or complete closure of the upper airway resulting in disturbed breathing during sleep. It is associated with decreased quality of life and significant medical comorbidities. Untreated OSA can lead to a host of cardiovascular diseases including coronary artery disease, stroke, and atrial fibrillation. Patients who report symptoms of snoring, witnessed apneas, or daytime sleepiness should be screened for sleep apnea. In-laboratory attended diagnostic polysomnography or portable home sleep testing can be used to diagnose sleep apnea. Continuous positive airway pressure (CPAP) therapy is the first-line treatment for OSA in adults. Other modalities include mandibular advancement devices, surgery, or upper airway stimulation therapy. Adjunctive therapy should include weight loss in overweight patients, avoidance of sedatives and alcohol before sleep, and possibly positional therapy.
睡眠相关呼吸障碍或睡眠呼吸紊乱的特征是睡眠期间呼吸异常。它们分为阻塞性睡眠呼吸暂停（OSA）、中枢性睡眠呼吸暂停、睡眠相关通气不足和睡眠相关低氧血症障碍。OSA是家庭医学环境中常见的一种疾病，由于肥胖流行以及公众和医生的认识提高，其越来越受到认可。OSA的特征是上气道反复出现部分或完全闭合，导致睡眠期间呼吸紊乱。它与生活质量下降和严重的医学合并症相关。未经治疗的OSA可导致一系列心血管疾病，包括冠状动脉疾病、中风和心房颤动。报告有打鼾、目击性呼吸暂停或日间嗜睡症状的患者应接受睡眠呼吸暂停筛查。实验室监测的诊断性多导睡眠图或便携式家庭睡眠测试可用于诊断睡眠呼吸暂停。持续气道正压通气（CPAP）治疗是成人OSA的一线治疗方法。其他治疗方式包括下颌前移装置、手术或上气道刺激治疗。辅助治疗应包括超重患者的体重减轻、睡前避免使用镇静剂和酒精，以及可能的体位治疗。
