BAppScExSS, MPhty, MBBS, Otolaryngology, Head @ Neck registrar, Wollongong Hospital; Illawarra ENT Head and Neck Clinic Wollongong, NSW.
BEng, MBBS, MEpi, Fellow in Sleep Surgery @ Otolaryngology, Head @ Neck Surgery, Wollongong Hospital; Illawarra ENT Head and Neck Clinic, Wollongong, NSW; University of Queensland, Qld.
Aust J Gen Pract. 2019 Apr;48(4):182-186. doi: 10.31128/AJGP-10-18-4749.
BACKGROUND: Obstructive sleep apnoea (OSA) is common in adults. Various contributing factors to this condition have resulted in the development of a number of potential treatment modalities, some of which are in evolution. A multidisciplinary team involving the general practitioner is an important aspect in providing personalised care. OBJECTIVE: The aim of this review is to provide a clinical update on the recent developments and future directions in adult OSA management. DISCUSSION: In-lab polysomnography remains important in the diagnosis of OSA, although home sleep studies have good specificity and sensitivity in particular subgroups of patients. First-line therapy in adult OSA is continuous positive airway pressure, with mandibular advancement splints and surgical intervention considered second-line. Adjunctive therapies include weight loss, avoidance of supine sleep, management of nasal obstruction, alcohol intake limitation and exercise. Advancements in medications targeting multiple neurophysiological pathways, and surgical insertion of hypoglossal nerve stimulator devices represent possible future treatment pathways in Australia.
背景:阻塞性睡眠呼吸暂停(OSA)在成年人中很常见。导致这种情况的各种因素导致了许多潜在治疗方法的发展,其中一些正在不断发展。一个多学科团队,包括全科医生,是提供个性化护理的重要方面。
目的:本综述旨在提供成人 OSA 管理方面的最新进展和未来方向的临床更新。
讨论:尽管在特定亚组患者中,家庭睡眠研究具有良好的特异性和敏感性,但在实验室进行多导睡眠图仍然是 OSA 诊断的重要手段。成人 OSA 的一线治疗是持续气道正压通气,下颌前伸夹板和手术干预被认为是二线治疗。辅助治疗包括减肥、避免仰卧睡眠、管理鼻阻塞、限制酒精摄入和锻炼。针对多种神经生理途径的药物治疗的进展以及舌下神经刺激器装置的外科植入可能代表澳大利亚未来的治疗途径。
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