Obstructive sleep apnea (OSA) is a disorder caused by the repetitive collapse of the upper airway during sleep. It is the
在支持喉咙中的软组织的肌肉，如舌头和软腭，放松时，OSA发生。这导致你的气道缩小甚至关闭，瞬间脱掉呼吸。
Normally, air should flow smoothly from the mouth and nose into the lungs at all times, including during sleep.
呼吸完全停止时的时期apnea或送道发作。在OSA，整个夜晚反复停止空气的正常流动。
OSA在老年男性中最常见，但它可能会影响任何人，包括儿童。发病率升高menopause，使得男性和绝经后妇女的速率相似。
打鼾通常与OSA相关联，特别是如果打鼾被沉默的时期中断。打鼾是由通过狭窄的气道空间挤压的气流引起的。
It is important to remember that snoring doesn’t necessarily indicate something potentially serious, and not everyone who snores has OSA.
Untreated OSA can cause serious health problems such as:
- high blood pressure(hypertension)
- heart disease
- 中风
- diabetes
- atrial fibrillation(abnormal heart rhythm)
- pulmonary hypertension
适当的诊断和治疗对于预防并发症至关重要。
大多数人与OSA抱怨白天嗜睡。OSA导致对大脑和身体其他部位降低的氧气供应剧集，因此睡眠质量差。这导致白天嗜睡和缺乏清晰度。
与OSA人士共用床的人可以报告以下内容：
- 大声打鼾
- gasping
- choking
- snorting
- interruptions in breathing while sleeping
These symptoms are also often detected when checking on another complaint or during health maintenance screening.
People with OSA may also experience the following symptoms:
- morninghead
- feeling disgruntled or grumpy
- 忘记
- 睡意
- repetitive awakenings throughout the night
其他症状包括：
- hyperactivityin children
- worseningdepression
- poor job and school performance
- loss of interest in sex
Daytime drowsiness puts people with sleep apnea at risk for motor vehicle crashes and industrial accidents. Treatment can help to completely relieve daytime drowsiness.
The following are some conditions associated with OSA:
- 肥胖障碍综合征，a呼吸紊乱在肥胖的人
- 内分泌条件，如甲状腺功能亢进,acromegaly, andpolycystic ovary syndrome, which may affect your breathing when you’re asleep
- chronic lung disease, such asasthma,chronic obstructive pulmonary disease (COPD), andpulmonary fibrosis
- 神经肌肉状况，如中风，这可能会干扰脑肌肉和气道的脑信号
- heartorkidney失败，可能导致液体在颈部积聚并阻碍上部气道
- pregnancy
如果您有缩小上部气道的物理功能，OSA的风险会增加。OSA的危险因素包括：
- obesity
- large tonsils
- men with a collar size of 17 inches or more
- women with a collar size of 16 inches or more
- a large tongue, which can block the airway
- retrognathia，这是你的下颌短于上颌短
- a narrow palate or airway that collapses more easily
- smoking
- family history of OSA
A diagnosis of sleep apnea begins with a complete history and physical examination. A history of daytime sleepiness and snoring are important clues.
Your doctor will examine your head and neck to identify any physical factors that are associated with sleep apnea.
Your doctor may ask you to fill out a questionnaire about daytime drowsiness, sleep habits, and quality of sleep.
In some cases, the evaluation for OSA may be performed at home without a technician in attendance. However, home sleep apnea testing is only useful for the diagnosis of OSA in certain people. It is not a substitute for other diagnostic tests if other sleep disorders are suspected.
The following tests may be performed to diagnose OSA.
Polysomnography (PSG)
During aPolysomNography., you sleep overnight in a hospital or sleep center while connected to a variety of monitoring devices that record physiologic variables.
在睡眠期间的生理异常模式may indicate sleep-disordered breathing as well as many other sleep disorders.
While you sleep, the PSG will measure the activity of different organ systems associated with sleep. It may include:
- electroencephalogram (EEG), which measures brain waves
- electrooculogram (EOM), which measures eye movement
- 肌电图（EMG），测量肌肉活动
- electrocardiogram (ECG), which measures heart rate and rhythm
- 脉冲血氧测定试验, which measures changes in your oxygen levels in your blood
eeg和eom
在脑电图中，电极连接到您的头皮，该头皮将在睡眠之前，期间和之后监控脑波。EOM记录眼球运动。
将小电极放置在右眼外部上部拐角处1厘米，另一个位于左眼外下角下方1厘米。当您的眼睛远离中心时，记录这种运动。
脑波和眼睛运动告诉医生关于睡眠不同阶段的时间。睡眠的两个广泛阶段是非REM（非快速眼球运动）和REM（快速眼球运动）。
Decreased muscle tone and paralysis occur during REM sleep.
EMG
During an EMG, two electrodes are placed on your chin: one above your jawline and the other below it. Other electrodes are placed on each shin.
The EMG electrodes pick up the electrical activity generated during muscle movements. Muscle relaxation should occur during sleep. The EMG picks up when your muscles relax and move while you’re sleeping.
心电图
A single lead ECG records the electrical signals from your heart during the sleep study to monitor your heart rate and rhythm.
Pulse oximetry
在该测试中，称为脉冲血氧计的装置被夹在身体的薄区域上，其具有良好的血流，例如指尖或耳垂。
The pulse oximeter uses a tiny emitter with red and infrared LEDs to measure the oxygen saturation level of your blood. This level may decrease during episodes of apnea.
The goal for the treatment of OSA is to make sure airflow isn’t obstructed during sleep. Treatment methods include the following:
Weight loss
Weight management通常为OSA的人建议使用肥胖的人。
Although it may not lead to complete remission, weight loss
减肥，如果你的医生推荐它，也可以降低血压，提高你的生活质量，减少白天嗜睡。
Continuous positive airway pressure (CPAP)
连续正气道压（CPAP）治疗is the first line of treatment for OSA. It is administered through a face mask worn at night.
The face mask gently delivers positive airflow to keep the airways open at night. The positive airflow props the airways open.
CPAP is a highly effective treatment for OSA.
For people with mild or moderate OSA who don’t benefit from CPAP therapy, anoral appliance是积极气道压力的合理替代品。
Bilevel positive airway pressure (BPAP)
Bilevel positive airway pressure (BPAP) machinesare sometimes used for the treatment of OSA if CPAP therapy is not effective.
BPAP machines, sometimes called BiPAP machines, have settings that deliver two pressures in response to your breathing: inhaled pressure and exhaled pressure. This means the pressure changes during inhaling versus exhaling.
Sleeping on your side
Since sleeping on your back (supine position) can make OSA worse for some people, positional therapy is used to help you learn to sleepon your side.
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手术
There is no consensus regarding the role of surgery in adult patients with OSA. In general, you may consider surgical therapy when CPAP or BPAP machines or an oral appliance aren’t effective.
Surgical treatment may be the most effective for people who have OSA due to a severe, surgically correctable, obstructing lesion of the upper airway.
Being a surgical candidate depends on factors such as:
- 你想要手术的愿望
- 如果您有手术纠正问题
- your overall health to undergo surgery
Surgical evaluation begins with a physical exam to check on the anatomy of your upper airway.
In addition, your doctor will insert a flexible喉镜检查, a thin instrument inserted through your nose that lights and magnifies the upper airway, while you are awake or, if necessary, asleep.
Surgical treatment for OSA provides long-term benefits in some patients, although the complete elimination of OSA is often not achieved, depending on the specific procedure.
You should always talk with your doctor if you’re experiencing daytime drowsiness or having consistent problems sleeping.
OSA has many treatment options to help you manage symptoms. Your doctor will create a treatment plan that combines lifestyle changes and other therapies.