Strollo P J, Sanders M H
Wilford Hall Medical Center, Lackland Air Force Base, Texas.
Sleep. 1993 Aug;16(5):403-8.
Snoring has been associated with an increased risk of vascular morbidity and mortality and with the complaint of excessive daytime sleepiness. Much of this risk may be attributable to concomitant sleep apnea or hypopnea. Recent work suggests that in certain individuals, snoring without apnea or hypopnea can lead to sleep disruption. This appears to be due to augmented ventilatory effort in response to an increased "internal" resistive load that results in repetitive arousals from sleep. This condition has been termed the upper airway resistance syndrome (UARS). Identification of load-related arousals in patients with the UARS may require the addition of esophageal pressure monitoring to the diagnostic polysomnogram. Nasal continuous positive airway pressure (CPAP) effectively eliminates snoring, hypopnea and apnea and therefore may be useful in treating this form of sleep-disordered breathing. The diagnostic criteria and indications, if any, for chronic treatment of these nonapneic snorers with nasal CPAP as well as long term compliance remain to be determined.
打鼾与血管疾病的发病率和死亡率增加以及白天过度嗜睡的主诉有关。这种风险很大程度上可能归因于同时存在的睡眠呼吸暂停或呼吸不足。最近的研究表明，在某些个体中，无呼吸暂停或呼吸不足的打鼾会导致睡眠中断。这似乎是由于对增加的“内部”阻力负荷做出反应而增强的通气努力，从而导致反复从睡眠中觉醒。这种情况被称为上气道阻力综合征（UARS）。识别UARS患者中与负荷相关的觉醒可能需要在诊断性多导睡眠图中增加食管压力监测。鼻持续气道正压通气（CPAP）可有效消除打鼾、呼吸不足和呼吸暂停，因此可能有助于治疗这种形式的睡眠呼吸障碍。对于使用鼻CPAP对这些非呼吸暂停性打鼾者进行长期治疗的诊断标准和适应症（如果有的话）以及长期依从性仍有待确定。
