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
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
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
诊断性检查
首要检查
- 夜间多导睡眠描记术
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
治疗流程
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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