睡眠呼吸暂停低通气综合征的长期管理:持续气道正压通气治疗的疗效与挑战——一篇叙述性综述

Long-Term Management of Sleep Apnea-Hypopnea Syndrome: Efficacy and Challenges of Continuous Positive Airway Pressure Therapy-A Narrative Review.

作者信息

Rahman Zishan, Nazim Ahsan, Mroke Palvi, Ali Khansa, Allam M D Parbej, Mahato Aakash, Maheshwari Mahveer, Cruz Camila Sanchez, Baig Imran, Calderon Martinez Ernesto

机构信息

Department of Medicine, Caribbean Medical University, Rosemont, IL 60018, USA.

Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro 76060, Pakistan.

出版信息

Med Sci (Basel). 2024 Dec 30;13(1):4. doi: 10.3390/medsci13010004.

Abstract

Sleep apnea-hypopnea syndrome (SAHS) is a respiratory disorder characterized by cessation of breathing during sleep, resulting in daytime somnolence and various comorbidities. SAHS encompasses obstructive sleep apnea (OSA), caused by upper airway obstruction, and central sleep apnea (CSA), resulting from lack of brainstem signaling for respiration. Continuous positive airway pressure (CPAP) therapy is the gold standard treatment for SAHS, reducing apnea and hypopnea episodes by providing continuous airflow. CPAP enhances sleep quality and improves overall health by reducing the risk of comorbidities such as hypertension, type 2 diabetes mellitus, cardiovascular disease and stroke. CPAP nonadherence leads to health deterioration and occurs due to mask discomfort, unsupportive partners, upper respiratory dryness, and claustrophobia. Technological advancements such as auto-titrating positive airway pressure (APAP) systems, smart fit mask interface systems, and telemonitoring devices offer patients greater comfort and enhance adherence. Future research should focus on new technological developments, such as artificial intelligence, which may detect treatment failure and alert providers to intervene accordingly.

摘要

睡眠呼吸暂停低通气综合征(SAHS)是一种呼吸系统疾病,其特征是睡眠期间呼吸停止,导致白天嗜睡和各种合并症。SAHS包括由上呼吸道阻塞引起的阻塞性睡眠呼吸暂停(OSA)和因缺乏脑干呼吸信号而导致的中枢性睡眠呼吸暂停(CSA)。持续气道正压通气(CPAP)治疗是SAHS的金标准治疗方法,通过提供持续气流来减少呼吸暂停和低通气发作。CPAP通过降低高血压、2型糖尿病、心血管疾病和中风等合并症的风险来提高睡眠质量并改善整体健康状况。CPAP治疗依从性差会导致健康状况恶化,其发生原因包括面罩不适、伴侣不支持、上呼吸道干燥和幽闭恐惧症。自动调压气道正压通气(APAP)系统、智能贴合面罩接口系统和远程监测设备等技术进步为患者提供了更大的舒适度并提高了依从性。未来的研究应专注于人工智能等新技术的开发,这些技术可能会检测到治疗失败并提醒医护人员进行相应干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a58/11755547/66e62d226c55/medsci-13-00004-g001.jpg

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