睡眠呼吸中止症簡介(下)

在這次的介紹中, 我們會把重點放在睡眠呼吸中止症的診斷及相關風險方面

那我有沒有阻塞型睡眠呼吸中止症呢？

    有許多症狀都跟阻塞性睡眠呼吸中止症相關, 例如最常見的兩個症狀就是慢性打呼以及白天嗜睡。但是如果真的要選一個最能預測睡眠呼吸中止症的症狀的話, 那應該可以用 ”夜間嗆醒“ (Nocturnal choking or gasping) 來做一個初步的評估。根據研究, 當出現有 ”夜間嗆醒“ 時, 有很高的機會可以確診阻塞型睡眠呼吸中止症 (sensitivity 52%, specificity 84%)。(8)

該如何確診睡眠呼吸中止症呢？

    在睡眠檢查室中,  接受多頻式睡眠檢查(Polysomnography)是診斷睡眠呼吸中止症的黃金標準。檢查方式十分簡單, 由於我們要檢查的是睡眠時呼吸道的狀態, 所以檢查是在夜間及凌晨時進行, 在醫師安排好檢查之後, 你可以洗好澡, 吃完晚餐, 帶著明天早上要上班的換洗衣物, 直接到睡眠檢查室報到, 在檢查室裡, 睡眠檢查技師會將各種檢測的儀器連接至您身上, 接著只需要放輕鬆一覺到天明就可以了, 隔天睡醒時就是檢查做完的時候, 您可以換好衣物後正常上班, 完全不會影響白天的正常作息。

多頻式睡眠檢查時, 會在睡眠時監測許多指標, 為醫師提供睡眠結構的資訊

睡眠呼吸中止症可能引起什麼問題呢？

日間生活功能失常: 由於阻塞性睡眠呼吸中止症會造成白天嗜睡,疲累,注意力   不集中, 所以白天的生活, 工作, 甚至認知功能都可能受到影響(3,9-12)

交通意外: 研究顯示, 在有阻塞性睡眠呼吸中止症的病人中, 發生車禍的機會是正常人的2-3倍(9)。研究也顯示成功治療可以顯著的提升車輛駕駛的專注力並且減少車禍機會。

心血管疾病: 有阻塞型睡眠呼吸中止症的病患, 尤其是中重度的患者, 比一般人更容易得到心血管的疾病, 其中包括全身性高血壓, 肺動脈高壓, 冠狀動脈疾病, 心律不整, 心臟衰竭甚至腦中風。

代謝性症候群及第二型糖尿病: 許多有睡眠呼吸中止症的病患都有體重過重的問題, 所以當研究顯示這些組群也容易有代謝性症候群及第二型糖尿病時(13,14), 臨床醫師並不感到意外, 但是也有其他進一步的研究顯示, 即使排除掉體重因素之後, 有睡眠呼吸中止症的病人仍然比一般人更容易有代謝性症候群及第二型糖尿病(15-17), 這種情形在重度睡眠呼吸中止症中更為明顯(17)

非酒精性指肪肝: 研究顯示有阻塞型睡眠呼吸中止症的病人比一般人容易有非酒精性脂肪肝, 目前推測可能的原因是和低血氧造成的發炎反應相關(18,19)

透過以上的說明, 希望您能對睡眠呼吸中止症有所了解, 其實要診斷睡眠呼吸中止症不是件困難的事, 如果真的有睡眠方面的困擾, 請找個時間到醫院找醫師討論看看喔 ! 

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參考資料:

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