中枢性睡眠呼吸暂停

最后审阅: 6 十一月 2022
最后更新: 28 一月 2022

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 失眠,尤其是睡眠维持困难性失眠
  • 注意力不集中和注意力集中时间缩短
  • 床伴观察到睡眠中出现周期性呼吸或呼吸停止或鼾声
  • 短暂呼吸困难导致觉醒或入睡困难
  • 醒来后头痛
  • 主诉睡眠不解乏和/或白天困倦
  • 清醒时周期性呼吸
更多 关键诊断因素

其他诊断因素

  • 异常心律或出现第三、第四心音
  • 神经系统检查局灶异常
  • 神经肌肉无力
  • 内分泌紊乱病史
其他诊断因素

危险因素

  • 充血性心力衰竭
  • 卒中
  • 肾功能衰竭
  • 男性
  • 心房颤动
  • 年龄≥60岁
  • 使用阿片类药物
  • 脑干损伤
  • 神经肌肉无力
  • 肢端肥大症
  • 甲状腺功能减退
更多 危险因素

诊断性检查

首要检查

  • 夜间多导睡眠描记术
更多 首要检查

需考虑的检查

  • 血清促甲状腺激素
  • 血清肌酐
  • 心电图 (ECG)
  • 血清胰岛素样生长因子1(肢端肥大症检查)
  • 超声心动图
更多 需考虑的检查

治疗流程

急症处理

不伴陈-施呼吸:由于躯体疾病导致

不伴潮式呼吸:原发性(特发性)

伴潮式呼吸

高海拔导致的周期性呼吸

药物或物质滥用所致

治疗后出现的CSA

撰稿人

作者

Bernardo J. Selim, MD

Associate Professor of Medicine

Director of Respiratory Care Unit

Division of Pulmonary, Critical Care, and Sleep Medicine

Mayo Clinic

Rochester

MN

利益声明

BJS declares that he has no competing interests.

Lauren A. Tobias, MD

Assistant Professor of Medicine

Yale University School of Medicine

Department of Internal Medicine

Section of Pulmonary, Critical Care and Sleep Medicine

New Haven

CT

利益声明

LAT declares that she has no competing interests.

鸣谢

Dr Bernardo J. Selim and Dr Lauren A. Tobias would like to gratefully acknowledge Dr J. Shirine Allam, Dr Timothy I. Morgenthaler, and Dr Christine H. Won, previous contributors to this topic.

利益声明

JSA and TIM declare that they have no competing interests. CHW declares that she has been a speaker for Respironics CME.

同行评议者

Teofilo Lee-Chiong, MD

National Jewish Medical and Research Center

Denver

CO

利益声明

TLC has been reimbursed by the American College of Chest Physicians (ACCP), American Academy of Sleep Medicine, American Thoracic Society, and Cephalon, the manufacturer of modafinil, for attending several conferences. He has been paid by the ACCP for running educational programs and by Elsevier for serving as consultant of the Sleep Medicine Clinics. He has also received research funding from the National Institutes of Health, Respironics, Restore, and Schwarz Pharma, and has been a member of the speakers' bureau for GlaxoSmithKline.

John A. Fleetham, MD, FRCP

Professor

University of British Columbia

Vancouver

Canada

利益声明

JAF declares that he has no competing interests.

  • 鉴别诊断

    • 阻塞性睡眠呼吸暂停
    • 睡眠相关低通气/低氧综合征
    • 抑郁
    更多 鉴别诊断
  • 指南

    • AASM 睡眠及相关事件评分手册
    • 德国 S3 指南非恢复性睡眠/睡眠障碍,章节:成人睡眠相关呼吸障碍
    更多 指南
  • 患者教育信息

    成人睡眠呼吸暂停(阻塞性)

    更多 患者教育信息
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