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[睡眠呼吸暂停综合征的适应症。何时以及为何进一步评估有意义?]

[Indications in sleep-apnea syndrome. When and why is further assessment meaningful?].

作者信息

Bloch K E, Russi E W

机构信息

Abteilung Pneumologie, Departement für Innere Medizin, Universitätsspital Zürich.

出版信息

Praxis (Bern 1994). 1997 Mar 11;86(11):437-41.

PMID:9190646
Abstract

Forms of sleep apnea syndrome: Interrupted breathing and hypoventilation during sleep lead to sleep disorders and to cardiovascular sequelae. In the common obstructive sleep apnea syndrome (OSAS) apneas are related to intermittent obstruction of the upper airways. In the rarer central sleep apnea syndrome certain cardiovascular or central nervous system disorders lead to disturbed regulation of respiration connected with periodic breathing. Signs indicating OSAS: Loud, cyclic snoring, interrupted by cessation of breathing during sleep observed by relatives and excessive daytime to diurnal sleepiness indicate OSAS. Furthermore alteration of personality, headache in the morning, non-refreshing sleep and nocturnal choking sensations may indicate OSAS. When is evaluation necessary? Patients with complaints possibly induced by OSAS should be further evaluated since nocturnal application of continuous positive airway pressure (CPAP) by means of a nose mask and other treatment forms often lead to significant improvement of OSAS. In addition patients with untreated OSAS have an increased risk for car accidents and premature death as consequence of cardiovascular diseases. The type and extent of a supposed respiratory disorder is evaluated by means of a sleep study.

摘要

睡眠呼吸暂停综合征的类型

睡眠期间呼吸中断和通气不足会导致睡眠障碍以及心血管后遗症。在常见的阻塞性睡眠呼吸暂停综合征(OSAS)中,呼吸暂停与上呼吸道的间歇性阻塞有关。在较为罕见的中枢性睡眠呼吸暂停综合征中,某些心血管或中枢神经系统疾病会导致与周期性呼吸相关的呼吸调节紊乱。提示OSAS的体征:亲属观察到睡眠期间响亮的、周期性的打鼾,伴有呼吸停止,以及白天过度嗜睡提示OSAS。此外,性格改变、晨起头痛、睡眠无恢复感和夜间窒息感也可能提示OSAS。何时需要评估?有OSAS可能诱发症状的患者应进一步评估,因为通过鼻罩夜间应用持续气道正压通气(CPAP)及其他治疗方式通常会使OSAS得到显著改善。此外,未经治疗的OSAS患者因心血管疾病发生车祸和过早死亡的风险增加。通过睡眠研究来评估疑似呼吸障碍的类型和程度。

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