Bloch K E
Departement Innere Medizin, Universitätsspital Zürich.
Schweiz Med Wochenschr. 1997 Feb 1;127(5):170-5.
Habitual snoring, nocturnal apnea, and excessive daytime sleepiness are leading symptoms of the obstructive sleep apnea syndrome. However, simple snoring without apnea is a more common and normal phenomenon. In certain habitual snorers increased upper airway resistance during sleep may lead to sleep fragmentation and hypersomnolence even in the absence of frank apnea; this condition is termed upper airway resistance syndrome. There is no convincing evidence that snoring in the absence of sleep apnea is an independent risk factor for cardiovascular disease. The evaluation of symptomatic snorers includes a specific history and physical exam, followed by a sleep study if treatment is considered necessary. The choice of treatment modality for snoring is guided by the individual needs and symptoms of the patient. Weight loss, nocturnal application of continuous positive airway pressure, or intraoral appliances which hold the mandible in protrusion during sleep are non-surgical treatment options. According to the patients' subjective assessment conventional or laser-assisted uvulo-palato-pharyngoplasty (UPPP) has a high cure rate for snoring. However, objective documentation of the effect of these interventions on measured snoring noise is scant.
习惯性打鼾、夜间呼吸暂停和日间过度嗜睡是阻塞性睡眠呼吸暂停综合征的主要症状。然而，单纯打鼾而无呼吸暂停是一种更为常见的正常现象。在某些习惯性打鼾者中，睡眠期间上气道阻力增加可能导致睡眠片段化和嗜睡，即使在没有明显呼吸暂停的情况下也是如此；这种情况被称为上气道阻力综合征。没有令人信服的证据表明无睡眠呼吸暂停的打鼾是心血管疾病的独立危险因素。对有症状的打鼾者的评估包括详细的病史和体格检查，如果认为有必要进行治疗，则随后进行睡眠研究。打鼾治疗方式的选择取决于患者的个体需求和症状。减肥、夜间应用持续气道正压通气，或在睡眠期间将下颌保持前突的口腔矫治器都是非手术治疗选择。根据患者的主观评估，传统的或激光辅助的悬雍垂腭咽成形术（UPPP）对打鼾有较高的治愈率。然而，关于这些干预措施对测量到的打鼾噪音影响的客观记录却很少。
