阻塞性睡眠呼吸暂停的特点是上呼吸道阵发性睡眠依赖性塌陷,导致周期性通气减少或停止,引发身体缺氧、高碳酸血症或睡眠唤醒。许多患者不知道自己的呼吸受到影响,也不会咨询医生评估呼吸睡眠暂停的评估。该病很常见,是机动车事故和心血管疾病的独立危险因素。家庭睡眠呼吸暂停测试可用于支持但不排除睡眠呼吸暂停的诊断。多导睡眠图被推荐用于已知或怀疑有卒中史,神经肌肉或肺功能障碍,通气不足或充血性心力衰竭或阿片类药物使用者。持续气道正压通气(CPAP)被认为是症状性或中重度睡眠呼吸暂停的一线治疗。对于拒绝或不能使用CPAP的患者,应根据梗阻性质,患者个体因素和偏好,个性化地考虑使用替代疗法(下颌前移装置和各种手术选择)。生活方式改善包括超重和肥胖患者的减肥咨询,避免药物和促进上呼吸道松弛的物质(如酒精、苯二氮卓类和麻醉剂),及警惕昏昏欲睡驾车风险并提供对策。

Obstructive sleep apnea is characterized by episodic sleep state–dependent collapse of the upper airway, resulting in periodic reductions or cessations in ventilation, with consequent hypoxia, hypercapnia, or arousals from sleep. Many patients are unaware that their breathing is affected and may not visit a physician for evaluation. The disease is commonand is an independent risk factor for motor vehicle accidents and cardiovascular disease. Home sleep apnea testing may be used to support, but not to rule out, the diagnosis of obstructive sleep apnea. Polysomnography is recommended in patients with a known or suspected history of stroke, a neuromuscular or pulmonary disorder with hypoventilation, or congestive heart failure or who are using opiates. Continuous positive airway pressure (CPAP) is considered first line therapy for symptomatic or moderate-to-severe obstructive sleep apnea. The use of alternative therapies (mandibular-advancement devices and various surgical options) for patients who decline or are unable to use CPAP should be considered on a personalized basis, with respect to the nature of obstruction, patient specific factors, and patient preferences. Recommended lifestyle modifications include weight loss counseling in overweight and obese patients, avoiding medications and substances that promote relaxation of the upper airway (e.g., alcohol, benzodiazepines, and narcotics), and increasing awareness of and providing counter measures for the risk of drowsy driving.