Effect of improved nasal breathing on obstructive sleep apnea
Effect of improved nasal breathing on obstructive sleep apnea
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DOI：
10.1016/s0194-5998(00)70147-1
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发表时间：
2000-01-01
影响因子：
3.4
通讯作者：
Caldarelli, D
中科院分区：
文献类型：
--
作者：
Friedman, M;Tanyeri, H;Caldarelli, D
目的：目的是通过主观和客观的测量方法比较改良的鼻气道对阻塞性睡眠呼吸暂停（OSA）的影响.方法：对50例连续的鼻气道阻塞和OSA患者进行前瞻性研究.结果：主观方面，49例（98%）患者鼻呼吸改善，17例（34%）患者打鼾减少或消失;其余33名（66%）患者没有注意到打鼾有任何显着变化。39例（78%）患者白天能量水平升高，11例（22%）患者保持不变或恶化。在回顾多导睡眠图数据时，该组总体上在呼吸紊乱指数（RDI）或最低血氧饱和度水平（LSaO（2））方面没有显著变化。鼻手术后纠正OSA所需的持续气道正压通气（CPAP）水平降低（P < 0.01）。轻度OSA患者RDI明显恶化（P < 0.05），中度OSA患者LSaO 2明显改善（P < 0.05）。在重度OSA患者中，RDI水平和LSaO（2）均无变化，但手术后缓解阻塞所需的CPAP水平降低（P < 0.01）。结论：大多数患者报告鼻气道阻塞纠正后鼻部和睡眠症状改善。然而，当客观地测量时，单独的鼻部手术并不能持续改善OSA。根据OSA的严重程度，鼻气道重建可能有助于CPAP水平的降低和氧饱和度的改善。阻塞性睡眠呼吸暂停综合征的整体治疗计划中当然应包括鼻气道阻塞的纠正。
OBJECTIVES: The goal was to compare the effect of an improved nasal airway on obstructive sleep apnea (OSA) by use of subjective and objective measures.METHODS: A prospective study of 50 consecutive patients with nasal airway obstruction and OSA was carried out.RESULTS: Subjectively, nasal breathing improved in 49 (98%) patients, whereas snoring decreased or disappeared in 17 (34%); the remaining 33 (66%) patients did not notice any significant change in their snoring. Daytime energy levels increased in 39 (78%) patients and remained unchanged or worsened in 11 (22%). In review of the polysomnographic data, the group overall did not have significant changes in respiratory disturbance index (RDI) or lowest oxygen saturation levels (LSaO(2)). Continuous positive airway pressure (CPAP) levels required to correct OSA decreased after nasal surgery (P < 0.01). Patients with mild OSA showed significant worsening in RDI (P < 0.05), whereas LSaO(2) levels were improved in the group with moderate OSA (P < 0.05). In patients with severe OSA neither the RDI levels nor the LSaO(2) changed, but CPAP levels required to alleviate the obstruction after surgery were reduced (P < 0.01).CONCLUSIONS: Most patients report improvement in nasal and sleep symptoms after correction of nasal airway obstruction. However, nasal surgery alone does not consistently improve OSA when measured objectively. Depending on the severity of OSA, nasal airway reconstruction may contribute to a decrease in CPAP level and improvement in oxygen saturation. Correction of the obstructed nasal airway should certainly be included in the overall treatment plan for OSA.