睡眠呼吸中止症的內科治療

Medical Treatment for Sleep Apnea

鄭景元(Ching-Yuan Cheng) ； 林嘉謨(Chia-Mo Lin)

《台灣醫學》 18卷2期 (2014/03) Pp. 204-208

https://doi.org/10.6320/FJM.2014.18(2).10

摘要

睡眠呼吸中止症（sleep apnea）是一種常見的睡眠障礙疾病，尤其以男性、老年人、肥胖、頸圍較粗、上呼吸道結構異常、鼻中膈彎曲等為高危險群。睡眠呼吸中止症依其病因可區分為阻塞型睡眠呼吸中止（obstructive sleep apnea）、中樞型睡眠呼吸中止（central sleep apnea）及混和型睡眠呼吸中止（mixed sleep apnea），其中以混合型最常見。睡眠呼吸中止症是一種慢性疾病，需長期治療，目前臨床上有多種治療方式，其中連續氣道正壓呼吸器（continuous positive airway pressure，CPAP）為主要治療方式，其他治療選擇包括配戴口腔矯正器（oral appliance）、行為治療、藥物輔助治療及外科手術治療等。臨床上依據病患之疾病嚴重度、危險因子、生理解剖構造及患者個人意願來選擇治療方式，通常需要數種治療方式多管齊下，以達到良好療效。

關鍵字

睡眠呼吸中止症 ； 內科治療 ； 連續氣道正壓呼吸器

並列摘要

Sleep apnea is a common sleep disorder, especially in those who are male, elder, obese, large neck circumference, abnormal airway structure or nasoseptal deviation. According to the type of sleep apnea, it can be divided to obstructive sleep apnea, central sleep apnea and mixed sleep apnea. Mixed sleep apnea is most commonly seen. There are multiple disciplines for the management of sleep apnea, and continuous positive airway pressure (CPAP) is most frequently used. Other choices of treatment include oral appliance, behavioral therapy, pharmacotherapy and surgery. How physicians treat sleep apnea depends on disease severity, risk factor, airway anatomy and choice of patients. Usually, combination therapies achieve optimal results.

並列關鍵字

sleep apnea ； continuous positive airway pressure(CPAP)

參考文獻

Bickelmann AG, Burwell CS, Robin ED, et al: Extreme obesity associated with alveolar hypoventilation; a Pickwickian syndrome. Am J Med 1956;21:811-8.

Epstein LJ, Kristo D, Strollo PJ Jr, et al: Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 2009;5: 263-76.

Sullivan CE, Issa FG, Berthon-Jones M, et al: Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. Lancet 1981;1:862-5.

Jenkinson C, Davies RJ, Mullins R, et al: Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised prospective parallel trial. Lancet 1999;353: 2100-5.

Stepnowsky CJ Jr, Moore PJ: Nasal CPAP treatment for obstructive sleep apnea: developing a new perspective on dosing strategies and compliance. J Psychosom Res 2003;54:599-605.