阻害性 スリープ アプネア の 診断 と 治療: レビュー
Daniel J Gottlieb1,2,3, Naresh M Punjabi4
1Medical Service, VA Boston Healthcare System, Boston, Massachusetts.
JAMA
|April 15, 2020
まとめ
阻害性睡眠無呼吸 (OSA) は一般的であり,肥満とともに増加しています. 有効な治療法があるが,特に無症状の場合,心血管疾患を減らすための証拠は限られている.
科学分野:
- 睡眠医学
- 心血管の健康
- 公衆衛生
背景:
- 阻害性睡眠無呼吸症 (OSA) は人口のかなりの部分に影響を与え,肥満率の上昇と関連している.
- 主な症状は昼間の過剰な眠気ですが,多くの患者は無症状のままです.
- OSAは心臓血管疾患と代謝疾患の主要な危険因子です.
研究 の 目的:
- 阻害性睡眠無呼吸 (OSA) の診断と治療に関する最新のレビューを提供するためです.
- OSAの健康への影響と利用可能な介入の現在の理解を強調する.
主な方法:
- OSAの診断と治療に関する現在の文献のレビュー.
- 睡眠時無呼吸検査を含む診断方法の分析
- OSAに対する様々な治療法の評価
主要な成果:
- 家庭での睡眠無呼吸検査は,OSAの診断に約80%の感度を持っています.
- 効果的な治療には,ライフスタイルの変更,陽性呼吸道圧 (PAP),口腔器具,外科手術,低光神経刺激が含まれます.
- PAP治療は 血圧を下げることができます 特に抵抗性高血圧の場合ですが 大規模な治験では 重要な心血管疾患の減少が示されていません
結論:
- OSAは,効果的な管理戦略を必要とする一般的な状態です.
- PAPのような治療は症状を改善し,血圧を下げることができますが,すべてのOSA患者,特に無症状の患者の心血管疾患を予防するためにその使用を支持する高品質の証拠は不足しています.
- 症状のないまたは症状が少ないOSA患者には行動介入が推奨されます.
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