A RANDOMIZED, CONTROLLED TRIAL OF TREATMENT FOR UPPER AIRWAY RESISTANCE SYNDROME

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 上呼吸道阻力综合征(UARS)于19931首次被描述为一种睡眠呼吸紊乱，有别于睡眠呼吸暂停/低呼吸综合征。根据早期对UARS的描述，它与睡眠呼吸暂停的不同之处主要在于在这两个综合征中观察到的睡眠时吸气流速受限的严重程度。与睡眠呼吸暂停患者相比，UARS患者睡眠时吸气流量较高，氧合血红蛋白降低较少，但有反复觉醒和日间嗜睡(与睡眠呼吸暂停患者相似)。随后的研究表明，UARS患者与睡眠呼吸暂停患者不仅在睡眠期间的吸气气流动力学方面不同，而且在其他症状和体征上也不同。具体地说，UARS患者有很高的睡眠发作性失眠、肠易激综合征、头痛(偏头痛和紧张型)和阿尔法波侵入NREM睡眠2。 尽管有证据支持从睡眠呼吸暂停中分离出来的睡眠呼吸紊乱综合征的存在，但一些研究人员质疑UARS是否应该被视为一种医学综合征。3相反，他们认为UARS是轻度呼吸暂停，而不是一种离散的病理生理。他们的怀疑是基于缺乏证据表明睡眠期间吸气流速限制与UARS患者的症状有关。他们认为，睡眠时吸气流速受限可以在没有UARS患者症状的个人身上观察到。此外，他们认为，鼻腔持续正压(CPAP)治疗后UARS患者嗜睡症状的改善从未与安慰剂鼻腔CPAP治疗进行过对比。因此，UARS作为一种需要治疗的独特诊断的存在仍然存在争议。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The upper airway resistance syndrome (UARS) was first described in 19931 as a form of sleep disordered breathing distinct from sleep apnea/hypopnea syndrome. Based upon the early descriptions of UARS, it differed from sleep apnea chiefly in the severity of inspiratory flow limitation during sleep observed in the two syndromes. UARS patients were observed to have higher inspiratory airflows during sleep with lesser oxy-hemoglobin desaturation than sleep apnea patients, but had recurrent arousals and daytime hyper-somnolence (similar to sleep apnea patients). Subsequent research demonstrated that UARS patients differ from sleep apnea patients not only in their inspiratory airflow dynamics during sleep, but also in other symptoms and signs. Specifically, UARS patients have a high prevalence of sleep onset insomnia, irritable bowel syndrome, headaches (migraine and tension-type) and alpha wave intrusion into NREM sleep2. Despite the evidence supporting the existence of a sleep disordered breathing syndrome discrete from sleep apnea, some researchers question whether UARS should be considered a medical syndrome.3 Rather, they view UARS as mild hypopnea and not as a discrete pathophysiology. Their doubt is based upon a lack of evidence that inspiratory flow limitation during sleep is associated with the symptoms of UARS patients. They argue that inspiratory flow limitation during sleep can be observed in individuals who lack the symptoms of UARS patients. Further, they argue that the improvement in the hyper-somnolence of UARS patients after nasal continuous positive airway pressure (CPAP) treatment has never been tested against a placebo nasal CPAP treatment. Thus, the existence of UARS as a distinctive diagnosis necessitating treatment remains controversial.