Paiva T, Vasconcelos P, Leitão A N, Andrea M
Laboratório de Sono, Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa.
Acta Med Port. 1993 Oct;6(10):449-56.
Our study included 42 patients with obstructive sleep apnea (OSAS) confirmed by polysomnography. In these patients we investigated the clinical manifestations, the results of the laboratory examinations, including polysomnography, ORL observations and tests of pulmonary function, as well as the therapeutic results. Our patients presented a serious set of symptoms which included excessive daytime sleepiness, snoring, obesity, cranio-facial abnormalities, systemic hypertension, cardiac arrhythmias, incapacity to work with precocious retirement, marital conflicts and high incidence of accidents, namely traffic accidents. An adequate treatment, mostly with nasal CPAP (continuous positive airway pressure), induced marked relief of the symptoms; some patients had an advantage in surgical treatment and weight reduction. OSAS is a frequent entity, affecting mostly male adults after the 5th decade. The lack of knowledge about this entity and the common social acceptance of some of its cardinal symptoms induces considerable delays in its diagnosis. The severity of the symptoms, the personal and social risks of excessive daytime sleepiness, the cardio-circulatory effects and the risk of sudden death during sleep justify an early diagnosis in order to prevent the severe evolution of the disease. Its complex physiopathology and multiple etiological factors justify a multidisciplinary approach.
我们的研究纳入了42例经多导睡眠图确诊为阻塞性睡眠呼吸暂停（OSAS）的患者。我们对这些患者的临床表现、实验室检查结果（包括多导睡眠图、耳鼻喉科观察及肺功能测试）以及治疗结果进行了调查。我们的患者呈现出一系列严重症状，包括日间过度嗜睡、打鼾、肥胖、颅面异常、系统性高血压、心律失常、因过早退休而无法工作、婚姻冲突以及事故（即交通事故）高发。适当的治疗，主要是采用鼻持续气道正压通气（CPAP），可使症状明显缓解；部分患者在手术治疗和减重方面有优势。OSAS是一种常见病症，主要影响50岁之后的成年男性。对该病症缺乏了解以及社会对其一些主要症状的普遍接受导致诊断出现相当大的延误。症状的严重性、日间过度嗜睡对个人和社会造成的风险、心血管循环影响以及睡眠期间猝死的风险，都说明早期诊断是合理的，以便预防疾病的严重进展。其复杂的生理病理学和多种病因促使采取多学科方法。
