Soori Rashmi, Baikunje Nandakishore, D'sa Ivor, Bhushan Navneet, Nagabhushana Belur, Hosmane Giridhar Belur
K S Hegde Medical Academy, Anaesthesiology and critical care - Mangalore - Karnataka - India.
K S Hegde Medical Academy, Pulmonary Mediicne - Mangalore - Karnataka - India.
Sleep Sci. 2022 Jan-Mar;15(Spec 1):285-288. doi: 10.5935/1984-0063.20220001.
Obstructive sleep apnoea (OSA) is the major underlying co-morbidity in many of the non-communicable diseases (NCD) due to obesity as a common risk factor. Incidence and prevalence of OSA is on the constant rise ever since this entity came to forefront three decades ago. Precise treatment of underlying OSA is extremely important in major NCDs like diabetes mellitus, hypertension, endocrine disorders and vascular diseases. OSA is subcategorized in to mild, moderate and severe based of apnoea-hypopnea index (AHI). Based on the severity grading, treatment of OSA ranges from life style modifications to oral appliances, continuous positive airway pressure (CPAP) and surgeries. AHI system of severity grading in OSA has several inherent shortcomings and using AHI system for severity grading as the holy grail is likely to be counter-productive. AHI system equates apnoea and hypopnea as equal events, whereas physiological effects vary significantly. AHI system does not account duration of apnoea or body position during apnoeic events. We discuss at length the pitfalls of AHI system of severity grading in OSA.
阻塞性睡眠呼吸暂停（OSA）是许多非传染性疾病（NCD）的主要潜在合并症，肥胖是其常见风险因素。自三十年前这一病症受到关注以来，OSA的发病率和患病率一直在持续上升。对潜在的OSA进行精准治疗在糖尿病、高血压、内分泌紊乱和血管疾病等主要非传染性疾病中极为重要。根据呼吸暂停低通气指数（AHI），OSA可分为轻度、中度和重度。根据严重程度分级，OSA的治疗范围从生活方式改变到口腔矫治器、持续气道正压通气（CPAP）和手术。OSA严重程度分级的AHI系统存在一些固有缺陷，将AHI系统作为严重程度分级的圣杯使用可能会适得其反。AHI系统将呼吸暂停和低通气视为同等事件，而其生理影响差异很大。AHI系统没有考虑呼吸暂停的持续时间或呼吸暂停事件期间的身体姿势。我们详细讨论了OSA严重程度分级的AHI系统的缺陷。
