Prolonged partial upper airway obstruction during sleep - an underdiagnosed phenotype of sleep-disordered breathing.
Prolonged partial upper airway obstruction during sleep - an underdiagnosed phenotype of sleep-disordered breathing.
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DOI：
10.3402/ecrj.v3.31806
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发表时间：
2016
影响因子：
1.9
通讯作者：
Saaresranta T
中科院分区：
文献类型：
--
作者：
Anttalainen U;Tenhunen M;Rimpilä V;Polo O;Rauhala E;Himanen SL;Saaresranta T
阻塞性睡眠呼吸暂停综合征(OSAS)是一种公认的疾病，传统上诊断为呼吸暂停低通气指数升高。长期的部分上呼吸道阻塞是睡眠障碍呼吸(SDB)的一种常见表型，但仍有很大程度的报道不足。其主要原因是，周期性呼吸模式与觉醒和动脉血氧饱和度相结合很容易被检测到，并且被认为比在没有循环呼吸模式和重复唤醒的情况下呼吸努力增加和二氧化碳水平增加的长时间发作更重要。也有越来越多的证据表明，长期的部分梗阻是SDB的一种临床重要形式，它与症状和合并症相关，可能与OSAS相关的部分不同。部分上呼吸道阻塞以女性最多见，用鼻腔持续正压装置治疗，依从性好。本文从诊断、病理生理学、临床表现和合并症等方面对睡眠中延迟性上呼吸道部分阻塞的特点进行综述，以提高对这种表型的认识和及时恰当的治疗。
Obstructive sleep apnea syndrome (OSAS) is a well-recognized disorder conventionally diagnosed with an elevated apnea–hypopnea index. Prolonged partial upper airway obstruction is a common phenotype of sleep-disordered breathing (SDB), which however is still largely underreported. The major reasons for this are that cyclic breathing pattern coupled with arousals and arterial oxyhemoglobin saturation are easy to detect and considered more important than prolonged episodes of increased respiratory effort with increased levels of carbon dioxide in the absence of cycling breathing pattern and repetitive arousals. There is also a growing body of evidence that prolonged partial obstruction is a clinically significant form of SDB, which is associated with symptoms and co-morbidities which may partially differ from those associated with OSAS. Partial upper airway obstruction is most prevalent in women, and it is treatable with the nasal continuous positive pressure device with good adherence to therapy. This review describes the characteristics of prolonged partial upper airway obstruction during sleep in terms of diagnostics, pathophysiology, clinical presentation, and comorbidity to improve recognition of this phenotype and its timely and appropriate treatment.