Karrer W
Luzerner Höhenklinik, Montana.
Praxis (Bern 1994). 1995 Apr 25;84(17):487-92.
Nocturnal sleep-associated breathing disorders have only been investigated thoroughly since about 15 years. From these studies it became clear that many respiratory disorders, in particular chronic obstructive ones, may severely impair nocturnal breathing and thus oxygen supply. by physiologically reduced ventilation at night, particularly in patients with already reduced pulmonary function, oxygen supply may become insufficient. In order to prevent late sequelae, early invalidity or precocious death, a comprehensive diagnostic approach is mandatory. Therapy consists of thorough anti-obstructive and anti-inflammatory inhalations, aided by additional oxygen supply during the night sleep in selected cases. Sleep-apnea syndrome is a frequent disease. About 3%, of males between 25 and 75 and at least 1% of females particularly after menopause, are affected. In most cases diagnosis can be suspected by clinical symptoms and nocturnal pulse oximetry. Sensitivity of pulse oximetry, however, is insufficient, thus polysomnography is necessary to establish the diagnosis and to control therapy. The most important therapeutic measure is to establish a nocturnal nasal continuous positive airway pressure (nCPAP) that may lead to immediate amelioration of symptoms and may normalize survival of patients. In particular, patients with obstructive sleep apnea should not drive motorized vehicles because of their excessive daytime sleepiness until a therapeutic success is evident. In this paper chronic obstructive pulmonary diseases, the central and the obstructive sleep-apnea syndrome are covered in particular.
夜间睡眠相关呼吸障碍直到大约15年前才得到充分研究。从这些研究中可以清楚地看出,许多呼吸系统疾病,尤其是慢性阻塞性疾病,可能会严重损害夜间呼吸,从而影响氧气供应。由于夜间生理通气量降低,特别是在肺功能已经降低的患者中,氧气供应可能会不足。为了预防晚期后遗症、过早残疾或过早死亡,必须采取全面的诊断方法。治疗包括彻底的抗阻塞和抗炎吸入治疗,在某些情况下,夜间睡眠时辅助额外吸氧。睡眠呼吸暂停综合征是一种常见疾病。25至75岁的男性中约3%、女性中至少1%受到影响,尤其是绝经后的女性。在大多数情况下,可以通过临床症状和夜间脉搏血氧饱和度测定怀疑诊断。然而,脉搏血氧饱和度测定的敏感性不足,因此需要进行多导睡眠图检查以确立诊断并控制治疗。最重要的治疗措施是建立夜间鼻持续气道正压通气(nCPAP),这可能会立即改善症状并使患者的生存率正常化。特别是,阻塞性睡眠呼吸暂停患者由于白天过度嗜睡,在治疗成功之前不应驾驶机动车辆。本文特别涵盖了慢性阻塞性肺疾病、中枢性和阻塞性睡眠呼吸暂停综合征。