Marin-Oto Marta, Vicente Eugenio E, Marin Jose M
1Department of Respiratory Medicine, Clinica Universitaria de Navarra, University of Navarra, Pamplona, Spain.
2Otorhinolaryngology Service, Hospital Universitario Miguel Servet, Zaragoza, Spain.
Multidiscip Respir Med. 2019 Jul 4;14:21. doi: 10.1186/s40248-019-0186-3. eCollection 2019.
Obstructive sleep apnea (OSA) is a worldwide highly prevalent disease associated with systemic consequences, including excessive sleepiness, impairment of neurocognitive function and daytime performance, including driving ability. The long-term sequelae of OSA include and increase risk for cardiovascular, cerebrovascular and metabolic syndrome disorders that ultimately lead to premature death if untreated. To ensure optimal long-term outcomes, the assessment and management of OSA should be personalized with the involvement of the appropriate specialist. Most studies have demonstrated inmediate improvement in daytime somnolence and quality of life with CPAP and other therapies, but the effect of long-term treatment on mortality is still under debate. Currently, the long-term management of OSA should be based on a) identifying physiological or structural abnormalities that are treatable at the time of patient evaluation and b) comprehensive lifestyle interventions, especially weight-loss interventions, which are associated with improvements in OSA severity, cardiometabolic comorbidities, and quality of life. In long-term management, attention should be paid to the clinical changes related to a potential reoccurrence of OSA symptoms and it is also necessary to monitor throughout the follow up how the main associated comorbidities evolve.
阻塞性睡眠呼吸暂停（OSA）是一种在全球范围内高度流行的疾病，会引发全身性后果，包括过度嗜睡、神经认知功能受损以及日间功能障碍，其中包括驾驶能力下降。OSA的长期后遗症包括心血管、脑血管和代谢综合征疾病风险增加，如果不加以治疗，最终会导致过早死亡。为确保获得最佳的长期治疗效果，OSA的评估和管理应在合适的专科医生参与下实现个性化。大多数研究表明，使用持续气道正压通气（CPAP）和其他疗法可使日间嗜睡和生活质量立即得到改善，但长期治疗对死亡率的影响仍存在争议。目前，OSA的长期管理应基于以下两点：a）识别在患者评估时可治疗的生理或结构异常；b）进行全面的生活方式干预，尤其是减肥干预，这与OSA严重程度、心脏代谢合并症和生活质量的改善相关。在长期管理中，应关注与OSA症状潜在复发相关的临床变化，并且在整个随访过程中监测主要相关合并症的发展情况也是必要的。
