阻塞性睡眠呼吸暂停低通气综合征和气道高反应性关系的研究进展

新近研究显示阻塞性睡眠呼吸暂停低通气综合征和气道高反应性关系密切,阻塞性睡眠呼吸暂停低通气综合征可通过神经机制、局部及系统性炎症、体液因素及胃食管反流等多种机制引起气道高反应性,且相应的持续气道内正压通气治疗亦与其相关.本文就阻塞性睡眠呼吸暂停综合征和气道高反应性关系的研究进展作一综述.     

阻塞性睡眠呼吸暂停低通气综合征与慢性咳嗽

阻塞性睡眠呼吸暂停低通气综合征是慢性咳嗽的病因之一.胃食管反流、鼻后滴流、气道炎症可能是阻塞性睡眠呼吸暂停低通气综合征诱发慢性咳嗽的机制.持续气道正压通气是有效治疗阻塞性睡眠呼吸暂停低通气综合征所致慢性咳嗽的首选治疗方案.     

阻塞性睡眠呼吸暂停与心血管疾病

本文分析关于阻塞性睡眠呼吸暂停与心血管疾病之间的关系、发生发展机制的最新进展,阐述对阻塞性睡眠呼吸暂停合并心血管疾病的患者行经鼻气道持续正压通气治疗能给患者心血管疾病的治疗、预后、康复和生活质量带来益处。本篇综述的目的在于引起医务工作者对阻塞性呼吸暂停与心血管疾病的关系的重视,从而服务于临床。     

阻塞性睡眠呼吸暂停与心血管疾病

本文分析关于阻塞性睡眠呼吸暂停与心血管疾病之间的关系、发生发展机制的最新进展,阐述对阻塞性睡眠呼吸暂停合并心血管疾病的患者行经鼻气道持续正压通气治疗能给患者心血管疾病的治疗、预后、康复和生活质量带来益处.本篇综述的目的 在于引起医务工作者对阻塞性呼吸暂停与心血管疾病的关系的重视,从而服务于临床.     

阻塞性睡眠呼吸暂停综合征合并高血压的临床研究

阻塞性睡眠呼吸暂停综合征(OSAS)患清醒及睡眠时血压变化情况及自动调节持续气道正压通气(Auto-CPAP)对其的治疗效果少有报道，我们对OSAS合并高血压的影响因素及治疗方法进行研究，以探讨OSAS与高血压的关系。     

经鼻持续气道内正压通气对阻塞性睡眠呼吸暂停综合征患者血压的影响

阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)是一种睡眠呼吸障碍性疾病,高血压是其最常见的并发症和合并症之一,近年来研究显示,OSAS引起的高血压多为难治性.常规药物降压效果较差.而经鼻持续气道内正压通气可以取得良好的疗效,本文就OSAS与高血压关系及经鼻持续气道内正压通气对OSAS患者血压影响的研究进展作相应综述.     

持续气道正压通气用于2型糖尿病伴阻塞性睡眠呼吸暂停低通气综合征患者治疗中的临床研究

目的分析2型糖尿病伴阻塞性睡眠呼吸暂停低通气综合征应用持续气道正压通气治疗的效果。方法选择2015年11月—2016年10月该院收治的70例2型糖尿病伴阻塞性睡眠呼吸暂停低通气综合征患者,分为两组,对照组实施常规治疗,研究组在此基础上给予持续气道正压通气治疗,比较两组临床治疗效果。结果经治疗后,研究组的AHI、MSpO_2、LSpO_2等指标改善情况均显著优于对照组,差异有统计学意义(P0.05)。两组治疗后的FBG差异无统计学意义(P0.05)。研究组与对照组的HbA1c、FINS、HOMA-IR指标比较,差异有统计学意义(P0.05)。结论对于2型糖尿病伴阻塞性睡眠呼吸暂停低通气综合征患者,临床给予持续气道正压通气治疗,能够有效缓解患者临床症状,改善其夜间低氧血症,增强胰岛素敏感性,可加强应用。     

高血压患者合并阻塞性睡眠呼吸暂停低通气综合征正压通气与外科治疗对血压的影响

阻塞性睡眠呼吸暂停低通气综合征（OSAHS）是一种能影响全身多脏器的常见疾病，尤其对高血压患者具有独立的危险因素。在高血压病人中，合并存在睡眠呼吸暂停综合征的患者应用降压药物控制血压极为困难，治疗效果差并被称为难治性高血压。轻中度睡眠暂停综合征的治疗方法是经鼻面罩持续气道正压（nCPAP）通气治疗，也是内科首选的最有效的治疗方法，而对于中重度OSAHS患者除nCPAP通气治疗外，部分病人常需要外科配合，以手术治疗更为有效。本研究旨在观察nCPAP通气治疗与外科手术配合对高血压合并OSAHS患者血压的影响。     

阻塞性睡眠呼吸暂停低通气综合征与心律失常的相关性

阻塞性睡眠呼吸暂停低通气综合征与心律失常关系密切,间歇性低氧和高碳酸血症、氧化应激和慢性炎症反应、交感迷走神经失衡、胸腔内压力改变、神经体液因子的激活等都是阻塞性睡眠呼吸暂停低通气综合征患者发生心律失常的可能病生理机制。阻塞性睡眠呼吸暂停低通气综合征与缓慢性心律失常、心房颤动、室性心律失常甚至心源性猝死密切相关,且能降低心律失常药物、电复律和射频导管消融等治疗的成功率,增加心房颤动复发的风险,而持续气道正压通气可以使阻塞性睡眠呼吸暂停低通气综合征患者的心律失常得到改善。     

持续气道内正压治疗阻塞性睡眠呼吸暂停低通气综合征的护理

阻塞性睡眠呼吸暂停低通气综合征（OSAHS）在临床上较为常见，人群患病率较高，成年男性患病率约为2％～4％。OSAHS患者睡眠时上气道反复塌陷、闭塞，导致呼吸暂停和（或）低通气，出现低氧和高碳酸血症，是高血压和冠心病等多种疾病的独立危险因素。持续气道内正压（CPAP）通气是治疗OSAHS的主要方法，主要机制是气道内正压使上气道撑开，并且由于呼气时气道内正压使肺残气量增高，也有助于维持上气道通畅。我们在2004年8月～2007年6月采用CPAP治疗OSAHS患者取得满意的疗效。     

Sleep disorders in patients with congestive heart failure

PURPOSE OF REVIEW: This review of recent literature pertains to the growing evidence that obstructive sleep apnea contributes to the development of systemic hypertension and congestive heart failure. RECENT FINDINGS: There is irrefutable evidence that OSA causes systemic hypertension and that continuous positive airway pressure (CPAP) treatment of OSA causes a reduction in blood pressure. Moreover there is evidence that untreated OSA is associated with left ventricular diastolic and systolic failure and that treatment with CPAP improves systolic function. SUMMARY: OSA should be considered in patients with systemic hypertension or heart failure.     

Effect of continuous positive airway pressure on symptoms of anxiety and depression in patients with obstructive sleep apnea

Sleep and Breathing - The objective was to assess the effect of continuous positive airway pressure (CPAP) on symptoms of anxiety and depression in patients with obstructive sleep apnea (OSA). We...     

A Randomized,Controlled, Pilot Study of CPAP for Patients with Chronic Cough and Obstructive Sleep Apnea

Lung - An association between chronic cough and obstructive sleep apnea (OSA) has been reported in prior studies with resolution or improvement in cough after continuous positive airway pressure...     

Cardiovascular consequences of obstructive sleep apnea syndrome

PURPOSE: This article is an update of past and current data on the relationship between obstructive sleep apnea syndrome and cardiovascular diseases. CURRENT KNOWLEDGE AND KEY POINTS: Obstructive sleep apnea syndrome is a common, but under-recognised, condition and should not be considered simplistically as the association of snoring and obesity. It may be suspected by the clinical history but a definite diagnosis requires the practice of polysomnography. Numerous studies have found a significant relationship between the presence of obstructive sleep apnea syndrome and the occurrence of cardiovascular events. Nonetheless, a definite causal relationship has only been established for the occurrence of hypertension. There are multiple immediate and delayed cardiovascular responses to the apneic events and thus there are many possible physiopathological mechanisms to explain the association of obstructive sleep apnea and cardiac and vascular events, the primary one being sympathetic hyperactivity. The prognosis of obstructive sleep apnea syndrome is closely related to the incidence of cardiovascular events. FUTURE PROSPECTS AND PROJECS: The existence of an independent relationship between obstructive sleep apnea syndrome and atherosclerosis is not yet demonstrated. The beneficial effects of continuous positive airway pressure, the treatment of choice for this condition, on the incidence of cardiovascular diseases remains to be confirmed although recent studies suggest that correct treatment of obstructive sleep apnea syndrome by continuous positive airway pressure may reduce the cardiovascular risk and in particular that of hypertension.     

Patient experience with upper airway stimulation in the treatment of obstructive sleep apnea

Sleep and Breathing - Selective upper airway stimulation (sUAS) is a new treatment modality for patients with obstructive sleep apnea (OSA) and continuous positive airway pressure (CPAP) failure....     

Economic evaluation of CPAP therapy for obstructive sleep apnea: a scoping review and evidence map

Sleep and Breathing - To synthesize findings of economic evaluations investigating cost-effectiveness of continuous positive airway pressure (CPAP) for obstructive sleep apnea (OSA) and of...     

Obstructive sleep apnea and heart failure

Obstructive sleep apnea (OSA) exerts several effects that may be particularly deleterious in patients with heart failure (HF). OSA should be considered especially in HF patients who are obese or have the metabolic syndrome, systemic hypertension, or pulmonary hypertension. HF patients in whom OSA is suspected should undergo a full evaluation by a sleep specialist, including a polysomnogram, to diagnose OSA and differentiate this disease from central sleep apnea. Those found to have OSA should then receive continuous positive airway pressure and/or other interventions, and standard disease management strategies should be used to maximize compliance. Those who cannot tolerate continuous positive airway pressure may be candidates for mandibular advancement devices or surgical therapies including tracheostomy. Standard HF medications should be used to treat HF, and optimization of fluid balance may help minimize OSA severity. However, it is still unknown whether treatment of OSA in HF patients will reduce hospitalizations or mortality.     

Advances in sleep-disordered breathing

Since the original clarification of the obstructive nature of obstructive sleep apnea (OSA) in 1965, much has been learned about the disorder. It is a condition with a high prevalence with obesity as a major risk factor. It aggregates in families, a relationship that is not simply explained by obesity. Premenopausal women are relatively protected from the disorder because OSA is uncommon in this group. Its prevalence in women rises after menopause. Although OSA is a risk factor for excessive sleepiness, there is developing evidence that it is also a risk factor for hypertension, acute cardiovascular events, and insulin resistance. The first line of therapy is nasal continuous positive airway pressure. Data as to the efficacy of continuous positive airway pressure in severe OSA have come from randomized, placebo-controlled clinical trials with the endpoints being sleepiness, quality of life, and 24-h ambulatory blood pressure. Data are currently less convincing for treatment outcomes in mild to moderate OSA, and new clinical trials to assess outcomes in this group are underway. Thus, even though this field only began toward the end of the first century of the American Thoracic Society, substantial progress has been made, and OSA has increasingly emerged as a major public health concern.     

Can we enhance compliance to treatment by performing a continuous positive airway pressure trial in obstructive sleep apnea?

Sleep and Breathing - Although continuous positive airway pressure (CPAP) therapy is the most effective treatment for obstructive sleep apnea (OSA), it is not always easy to gain adherence to...     

Effect of continuous positive airway pressure on gastroesophageal reflux in patients with obstructive sleep apnea: a meta-analysis

Sleep and Breathing - Gastroesophageal reflux disease (GERD) often occurs in patients with obstructive sleep apnea (OSA). Although continuous positive airway pressure (CPAP) is considered...