1、1 234567各各国国P8睡睡眠眠医医91011121314151617181920与与异异常常呼呼吸吸事事2122特特可自述，已经完全忘记了完全觉醒的体验n重度日间嗜睡的患者往往有很高的主观（ESS）和客观日间（MSLT）嗜睡测量的分离现象（不一致）n日间觉醒状态高的个体在急性夜间睡眠限制（Sleep Restriction）后，常常有最一致的主观和客观测量（MSLT和Theta活动）结果2324Alpha,Eye Movements,Steering&Lane Position2526Psychiatric illnessInsomniaOSASDaytime sleepinessFat
2、igue Attention,concentration and memory impairment Sleep disturbances AccidentsImpaired quality of lifeMedical consequencesAbsenteeism,Health care utilization27Hypno-sedatives:Contrib药药会会导导致致OSAS吗吗?28Prevalence of insomnia in OSASAS病病人人当当中中的的患患病病率率29OSAS在在打打鼾鼾与与失失眠眠为为主主诉诉病病人人的的患患病病5 51 12 22 21 1）30
3、OSAS在在打打鼾鼾与与失失眠眠为为主主3132NORMIHCIH*33Sjostrom et al.Thorax 2003Logan et al.J.Hypertension 2001Javaheri et al.Circulation 1999Schafer et al.Cardiology 1999 Sanner et al.Clin Cardiology 2001 Somers et al.Circulation 200434Franklin KA et al Lancet 2005;345:1085-7p0.05p0.0135未治疗未治疗OSA病人的房颤复发率增加病人的房颤复发率增加
4、36OSAS治疗后的Milleron et al Eur Heart J 2004373839内分泌疾病内分泌疾病肢端肥大症：多伴有多伴有SAHS,阻塞性和中枢性兼有。可见口阻塞性和中枢性兼有。可见口咽部肌肉组织和舌体肥大。咽部肌肉组织和舌体肥大。甲状腺功能减退症：造成造成舌体肥大舌体肥大,悬雍垂、软腭和舌根悬雍垂、软腭和舌根松弛松弛,口咽部狭窄、上气道塌陷气道阻塞。口咽部狭窄、上气道塌陷气道阻塞。糖尿病：糖尿病患者中糖尿病患者中SAHS SAHS 发病率是普通人群发病率是普通人群3 34 4倍。倍。可能与糖尿病的血管神经病变损害呼吸中枢及呼吸肌有关。可能与糖尿病的血管神经病变损害呼吸中枢及呼
5、吸肌有关。柯兴综合征：常伴有睡眠呼吸障碍，伴睡眠呼吸障碍患者常伴有睡眠呼吸障碍，伴睡眠呼吸障碍患者白天嗜睡更明显。白天嗜睡更明显。40Prevalence of sleep apnea in acromegaly in two cohorts in Sydney,Australia.In hospital 1,which has a sleep laboratory,almost all patients with acromegaly肢端肥大症 have sleep apnea.In hospital 2,a regional endocrine center without sleep investigation facilities,60%of patients have sleep apnea41CPAP 治疗改善OSAS患者的胰岛2004Insulin sensitivity index(ISI)at baseline,2 days,and 3 months after onset of continuous positive airway pressure(CPAP)treatment in 31 patients.4243
