Obstructive sleep apnea: current perspectives.
Obstructive sleep apnea: current perspectives.
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DOI：
10.2147/nss.s124657
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发表时间：
2018
影响因子：
3.4
通讯作者：
Eckert DJ
中科院分区：
文献类型：
--
作者：
Osman AM;Carter SG;Carberry JC;Eckert DJ
阻塞性睡眠呼吸暂停（OSA）的发病率持续上升。健康、安全和经济后果也是如此。在个体水平上，OSA的原因和后果在患者之间可能有很大差异。近年来，四个关键贡献者的OSA发病机制或“表型”已被表征。这些包括狭窄、拥挤或可塌陷的上气道“解剖学妥协”和“非解剖学”贡献者，诸如睡眠期间无效的咽扩张肌功能、睡眠期间唤醒气道狭窄的低阈值以及呼吸的不稳定控制（高回路增益）。这些表型中的每一种都是治疗的靶标。本文综述了OSA的不同贡献者的最新知识，重点是测量技术，包括新兴的临床工具，旨在促进翻译新的原因驱动的有针对性的方法来治疗OSA。还强调了OSA的一些特定病理生理原因驱动OSA的一些关键症状和后果的潜力。
The prevalence of obstructive sleep apnea (OSA) continues to rise. So too do the health, safety, and economic consequences. On an individual level, the causes and consequences of OSA can vary substantially between patients. In recent years, four key contributors to OSA pathogenesis or “phenotypes” have been characterized. These include a narrow, crowded, or collapsible upper airway “anatomical compromise” and “non-anatomical” contributors such as ineffective pharyngeal dilator muscle function during sleep, a low threshold for arousal to airway narrowing during sleep, and unstable control of breathing (high loop gain). Each of these phenotypes is a target for therapy. This review summarizes the latest knowledge on the different contributors to OSA with a focus on measurement techniques including emerging clinical tools designed to facilitate translation of new cause-driven targeted approaches to treat OSA. The potential for some of the specific pathophysiological causes of OSA to drive some of the key symptoms and consequences of OSA is also highlighted.