Obstrüktif uyku apne sendromu

Uyku sağlığın vazgeçilemez bir parçasıdır ve uykuda solunum bozuklukları hem toplum hem de kişisel olarak ciddi sağlık problemlerine, ekonomik kayıplara yol açabilmektedir. Uyku apnesinin en sık görülen tipi obstrüktif tiptir. Obezite, ileri yaş, erkek cinsiyet ve kısa-kalın boyun yapısı gibi bazı anatomik özelliklere sahip olmak risk faktörleri oluşturmaktadır. Gündüz uyku hali, horlama ve tanıklı apneler ise ana bulgulardır. Uykuda solunum bozuklukları için tanıda altın standart yöntem polisomnografidir. Bu hastalarada gündüz aşırı uyku hali nedeniyle trafik kaza oranı yüksektir. Uyku apne sendromu çok sayıda sistemik hastalık gelişimi açısından risk oluşturmakta ve birçok kardiyovasküler hastalığın etyopatogenezi ve ilerlemesinde rol oynamaktadır. Bu nedenle bu hastalara gecikilmeden tanı konulmalı ve uygun tedavi başlanmalıdır

Anahtar Kelimeler:

Yaygınlık, Tanı, Terapötikler, Risk faktörleri, Ölüm oranı, fizyopatoloji, Uyku apne, tıkayıcı

Obstructive sleep apnea

Sleep is a very important part of health and sleep related breathing disorders can cause serious health and economical problems for both socially and individually. The most common form of sleep apnea is obstructive type. Obesity, advanced age, male gender and anatomical disorders like short-thick neck type are common risk factors. The main symptoms are excessive daytime sleepiness, snoring and witnessed apnea. The gold standard for the diagnosis of sleep apnea is polisomnography. Traffic accidents are very common among these patients because of excessive daytime sleepiness. Sleep apnea is a risk factor for the development of many systemic diseases and it plays a major role in the etiopathogenesis and progression of cardiovascular diseases. So early diagnosis and adequate treatment should be started without any delay.

Keywords:

Prevalence, Diagnosis, Therapeutics, Risk Factors, Mortality, physiopathology, Sleep Apnea, Obstructive,

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1. ASDA-Diagnostic Classification Steering Committee. The International Classification of Sleep Disorders. Diagnostic and Coding Manual, Ed. 2, Lawrance, KS: Allen Press Inc 1997.
2. Lugaresi E, Cirignotta F, Coccagna G, Piana C. Some epidemiological data on snoring and cardiocirculatory disturbances. Sleep 1980;3: 221-4. 3. Yücel T. Horlama ve Obstrüktif uyku apne sendromu tedavisi. Hacettepe Tp Dergisi 2004;35: 222-6.
4. Schwab RJ, Goldberg AN, Pack AI. Sleep apnea syndromes. In: Fishman AP (Ed). Fishman's Pulmonary Diseases and Disorders. New york : McGraw Hill Book Company 1998: 1617-37.
5. Köktürk O. Obstrüktif uyku apne sendromu epidemiyolojisi. Tüberküloz ve Toraks Dergisi 1998;46: 193-201.
6. Isono S , Remmers JE. Anatomy and physiology of upper airway obstruction. In: Kryger MH, Roth T, Dement WC (Eds). Principles and Practice of Sleep Medicine. Philadelphia: W.B. Saunders Company 1994:642-56
7. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 1999;22: 667-89.
8. Meoli AL, Casey KR, Clark RW, Coleman JA Jr, Fayle RW, Troell RJ, et al. Hypopnea in sleep-disordered breathing in adults. Sleep 2001;24:469-70.
9. Lee-Chiong TL Jr. Monitoring respiration during sleep. Clin Chest Med 2003;24: 297-306.
10. Robinson A, Guilleminault C: Obstructive sleep apnea syndrome. In:Chokroverty S (ed). Sleep Disorders Medicine. Boston: Butterworth- Hienemann 1999: 331-54.
11. Krieger J. Clinical presentation of sleep apnoea. Eur Respir 1998; 10: 75–105.
12. Köktürk O. Obstrüktif uyku Apne Sendromu Klinik özellikleri. Tüberküloz ve Toraks Dergisi 1999;47: 117–26.
13. Badr MS. Pathophysiology of upper airway obstruction during sleep. Clin Chest Med 1998;19: 21-32.
14. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993;328: 1230-5.
15. Isono S, Remmers J. Anatomy and physiology of upper airway obstruction. Principles and Practice of Sleep Medicine–Kryger, Roth, Dement. WB Saunder’s Company 1994;63: 642-56.
16. Suratt P, Metier R, Wilhoit S. Upper airway muscle activitation is augmented in patients with obstructive sleep apnea campred with that in normal subjects. Am Rev Respir Dis 137: 889-94.
17. White D, Mezzanotte W. Neuromuscular compensetaion in the human upper airway. Sleep 1993;16: 90-2.
18. Douglas N, Polo O. Patogenesis of obstructive sleep apnea/ hypopnea syndrome. The Lancet 1994;344: 653-5.
19. Netzer N, Schuschnik M, Matthys H, Miles L, Steinacker J, Decker MJ, et al. Sleep and respiration at an altitude of 6,400 m. Pneumologie 1997;51: 729-35.
20. Carskadon MA, Dement WC. The Multiple Sleep Latency Test: what does it measure ? Sleep 1985;5: S67-S72.
21. Culebras A. Polysomnography. In Clinical handbook of sleep disorders. Butterworth–Heinemann, Boston 1996;91–117.
22. Johns MW. A new model for measuring daytime sleepiness: The Epworth Sleepiness Scale. Sleep 1991;14: 540.
23. Johns MW. Daytime sleepiness, snoring, and obstructive sleep apnea: The Epworth Sleepiness Scale. Chest 1993;103:30-6.
24. Krieger J, Weitzenblum E, Vandevenne A, Stierle JL, Kurtz D. Flow – volume curve abnormalities and obstructive sleep apnea syndrome. Chest 1985:87: 163–7.
25. Dursuno?lu D, Dur?uno?lu N. Cardiovascular diseases in obstructive sleep apnea. Tüberküloz ve Toraks dergisi 2006;54:382-96.
26. Paris JM, Somers VK. Obstructive sleep apnea and cardiovascular disease. Mayo Clin Proc 2004;79: 1036-46.
27. Findley LJ, Unverzagt ME, Suratt PM: Automobile accident involving patient with obstructive sleep apnea. Am Rev Respir Dis 1988;138: 337-40.
28. Saunamäki T, Jehkonen M. Depression and anxiety in obstructive sleep apnea syndrome: a review. Acta Neurol Scand 2007;116: 277-88.
29. Akashiba T, Kawahara S, Akahoshi T, Omori C, Saito O, Majima T, et al. Relationship between quality of life and mood or depression in patients with severe obstructive sleep apnea syndrome. Chest 2002;122: 861-5.
30. Fidan F, Ünlü M, Sezer M, Geçici O, Kara Z. Compliance to CPAP treatment and effects of treatment on anxiety and depression in patients with obstructive sleep apnea syndrome. Tuberk Toraks 2007;55: 271-7.
31. Hedner J, Grote L. Cardiovascular consequences of obstructive sleep apnea. Eur Respir Mon 1998;10: 227-65.
32. Phillips B. Sleep-disordered breathing and cardiovascular disease. Sleep Med Rev 2005;9: 131-40.
33. Lévy P, Pépin JL, Arnaud C, Tamisier R, Borel JC, Dematteis M, et al. Intermittent hypoxia and sleep-disordered breathing: current concepts and perspectives. Eur Respir J 2008;32: 1082-95.
34. Tosun A, Köktürk O, Karata GK, Çiftçi TU, Sepici V. Obstructive sleep apnea in ischemic stroke patients. Clinics 2008;63: 625-30.
35. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, evaluation, and Treatment of High Blood Pressure. JAMA 2003;21: 2560-72.
36. Dickins QS, Jenkins NA, Mrad R, Schweitzer PK, Walsh JK. Nasal continuous positive airway pressure in the treatment of obstructive sleep apnea. Oper Tech in Otolaryngol-Head and Neck Surg 1991;2: 91-5.
37. American Thoracic Society Board. Indications and standarts for use of nasal continuous positive airway pressure (CPAP) in sleep apnea syndromes. Am J Respis Crit Care Med 1994;150: 1738-45.