Tagaya M, Otake H, Suzuki K, Yasuma F, Yamamoto H, Noda A, Nishimura Y, Sone M, Nakashima T, Nakata S
Department of Otorhinolaryngology, Shirakabe clinic, Nagoya, Japan.
Department of Otorhinolaryngology, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
Rhinology. 2017 Sep 1;55(3):269-273. doi: 10.4193/Rhin17.026.
Residual sleepiness after continuous positive airway pressure (CPAP) is a critical problem in some patients with obstructive sleep apnea syndrome (OSAS). However, nasal surgery is likely to reduce daytime sleepiness and feelings of unrefreshed sleep. The aim of this study is to clarify the effects of nasal surgery and CPAP on daytime sleepiness.
This is a retrospective and matched-case control study. The participants were consecutive 40 patients with OSAS who underwent nasal surgery (Surgery group) and 40 matched patients who were treated with CPAP (CPAP group).
In the Surgery group, although the nasal surgery did not decrease either apnea or hypopnea, it improved oxygenation, the quality of sleep. In the CPAP Group, the CPAP treatment reduced apnea and hypopnea, and improved oxygenation, quality of sleep. The degree of relief from daytime sleepiness was different between the two groups. The improvement of Epworth Sleepiness Scale was more significant in the Surgery Group than those in the CPAP Group (Surgery from 11.0 to 5.1, CPAP from 10.0 to 6.2).
These findings suggest that the results of the nasal surgery is more satisfactory for some patients with OSAS than CPAP on daytime sleepiness.
对于一些阻塞性睡眠呼吸暂停综合征（OSAS）患者而言，持续气道正压通气（CPAP）治疗后仍存在残余嗜睡是一个关键问题。然而，鼻部手术可能会减轻日间嗜睡以及睡眠后仍感未恢复精力的状况。本研究旨在阐明鼻部手术和CPAP对日间嗜睡的影响。
这是一项回顾性匹配病例对照研究。参与者为连续纳入的40例行鼻部手术的OSAS患者（手术组）以及40例匹配的接受CPAP治疗的患者（CPAP组）。
在手术组中，尽管鼻部手术并未减少呼吸暂停或呼吸浅慢，但改善了氧合及睡眠质量。在CPAP组中，CPAP治疗减少了呼吸暂停和呼吸浅慢，并改善了氧合及睡眠质量。两组间日间嗜睡缓解程度有所不同。Epworth嗜睡量表的改善在手术组比CPAP组更显著（手术组从11.0降至5.1，CPAP组从10.0降至6.2）。
这些发现表明，对于一些OSAS患者，鼻部手术在改善日间嗜睡方面比CPAP更令人满意。
