文件阻塞性睡眠呼吸暂停低通气综合征概述生理学评估.pdfVIP

Overview ▪ Physiology of Sleep ▪ Evaluation of Sleep ▪ Definition of Obstructive Sleep Apnea Hyponea Syndrome(OSAHS) ▪ Pathophysiology of OSAHS ▪ Medical Treatment of OSAHS ▪ Surgical Treatment of OSAHS Physiology of Sleep Woodson, Tucker “Obstructive Sleep Apnea Syndrome, Diagnosis and Treatment” 1996 ▪ REM ( rapid eye movements Sleep) more likely to occur ▪ Arousal Evaluation of Sleep ▪ Polysomnography ▪ EMG ▪ Airflow ▪ EEG, EOG ▪ Oxygen Saturation ▪ Cardiac Rhythm ▪ Leg Movements Evaluation of Sleep ▪ Polysomnography(PSG) Woodson, Tucker “Obstructive Sleep Apnea Syndrome, Diagnosis and Treatment” 1996 Evaluation of Sleep ▪ Polysomnography(PSG) Gold standard ▪ Epworth Sleepiness Scale ▪ Multiple Slee tency Test Definition of OSAHS ▪ Apnea is defined as cessation of airflow for ten seconds which results in an arousal. If the chest wall continues to mechanically move during this time, then it is an obstructive apnea. If the chest wall does not attempt to ventilate, then it is presumably due to a neurologic etiology and is termed a central apnea. Sometimes there are characteristics of both an obstructive and a central apnea, and this is termed a mixed apnea. ▪ Hypopnea is considered a diminution in airflow which results in hypoxemia and results in an arousal. Definition of OSAHS ▪ the apnea-hypopnea index (AHI): the sum of apneas and hypopneas per hour ▪ AHI: 5 — 20 = mild ▪ AHI: 20 — 40 = moderate 20 reas sk of mortality ▪ AHI: 40 = severe Definition of OSAHS ▪ Snoring Patients with snoring who have an apne