폐쇄성 수면 무호흡 환자의 지속적 양압기 사용 후 재검사시수면다원검사 결과의 변화
Case of a Change in the Polysomnograpy Results after Using Continuous Positive Airway Pressure in a Patient with Obstructive Sleep Apnea
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
폐쇄성 수면 무호흡은 반복적인 상기도 저항으로 인해 호흡이 없는 상태를 말하며, 뇌 심혈관계 질환과의 연관성이 있어 적극적인 치료가 필요하다. 대표적인 방법인 지속적 양압기의 치료효과는 많은 연구로 입증되었다. 그러나 지속적 양압기 사용전과 후의 마스크를 착용하지 않은 상태에서의 수면다원검사결과를 비교한 것은 없다. 본 증례에서 폐쇄성 수면 무호흡으로진단된 환자가 2년 이상 꾸준히 지속적 양압기를 사용한 후 재검사를 통해 무호흡–저호흡 지수의 감소(64.7/h에서 12.9/h) 및 그 외 수면관련 지표들도 호전된 결과를 보였다. CPAP의 장기적 사용은 상기도 저항이 감소할 수 있는 기전을 제공하는 것으로 사료되며, 이로 인한 무호흡–저호흡 지수가 변화 가능성이있으므로 꾸준한 수면다원검사의 추적관찰이 필요하겠다.
Abstract
Obstructive sleep apnea (OSA) is a sleep disorder with no breathing symptoms due to repetitive upper airway resistance. OSA is a disease that can have significant effects on the cerebral cardiovascular system. Active treatment is needed to prevent these complications. The use of continuous positive airway pressure (CPAP), the standard therapy of OSA, has comparative therapeutic effects. On the other hand, there is no comparison report of the polysomnography (PSG) results before and after CPAP therapy without using a mask. This paper reports a patient who was diagnosed as OSA and used CPAP every night for more than 2 years. The patient showed a decrease in the apnea-hypopnea index from 64.7/h to 12.9/h. In addition, other sleep-related indicators improved significantly. The daily use of CPAP as a treatment for OSA for more than 2 years may improve the PSG results. Constant follow up of PSG will be needed to adjust the appropriate CPAP pressure to patients because there might be a change in the Apnea-Hypopnea Index and other sleep-related indicators for constant CPAP users for at least 2 years.
참고문헌 (18)
- Yun CH, "A diagnosis and treatment of obstructive sleep apnea syndrome", J Kor Sleep Research Soc, 1, pp.34~40 (2004)[DOI]
- EYAL SHAHAR, "Sleep-disordered Breathing and Cardiovascular Disease", American Journal of Respiratory and Critical Care Medicine, 163(1), pp.19~25 (2001), American Thoracic Society[DOI]
- Jie Li, "Is brain damage really involved in the pathogenesis of obstructive sleep apnea?", NeuroReport, 25, pp.593~595 (2014), Ovid Technologies (Wolters Kluwer Health)[DOI]
- 김천식, "혈압과 폐쇄성수면무호흡-저호흡증후군의 연관성", 대한임상검사과학회지, 46(3), pp.106~110 (2014), 대한임상검사과학회[DOI]
- Kapur VK, "Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea : an American Academy of Sleep Medicine clinical practice guideline", J Clin Sleep Med, 13, pp.479~504 (2017)[DOI]
- Gay P, "Evaluation of positive airway pressure treatment for sleep related breathing disorders in adults", Sleep, 3, pp.381~401 (2006)[DOI]
- Weaver TE, "Continuous positive airway pressure treatment for sleep apnea in older adults", Sleep Med Rev, 11, pp.99~111 (2007)[DOI]
- Frideman M, "Staging of obstructive sleep apnea", hypopnea syndrome : A guide to appropriate treatment, 2004, pp.114, 454~459
- Kushida CA, "Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances : an update for 2005", Sleep, 29, pp.240~243 (2006)[DOI]
- Aurora RN, "Practice parameters for the surgical modifications of the upper airway for obstructive sleep apnea in adults", Sleep, 33, pp.1408~1413 (2010)[DOI]
- Paul E. Peppard, "Longitudinal study of moderate weight change and sleep-disordered breathing", JAMA, 284(23), pp.3015~3021 (2000), American Medical Association (AMA)[DOI]
- Caples SM, "Surgical modifications of the upper airway for obstructive sleep apnea in adults : a systematic review and meta-analysis", Sleep, 33, pp.1396~1407 (2010)[DOI]
- Lee CH, "Analysis of upper airway obstruction by sleep videofluoroscopy in obstructive sleep apnea : a large population-based study", Laryngoscope, 122, pp.237~241 (2012)[DOI]
- Moos DD, "Obstructive sleep apnea and sedation in the endoscopy suite", Gastroenterol Nurs, 29, pp.456~463 (2006)
- Deacon NL, "Daytime loop gain is elevated in obstructive sleep apnea but not reduced by CPAP treatment", J Appl Physiol, 125, pp.1490~1497 (2018)[DOI]
- Younes M, "Chemical control stability in patients with obstructive sleep apnea", Am J Respir Crit Care Med, 163, pp.1181~1190 (2001)[DOI]
- Salloum A, "Increased propensity for central apnea in patients with obstructive sleep apnea : effect of nasal continuous positive airway pressure", Am J Respire Crit Care Med, 181, pp.189~193 (2010)[DOI]
- Kusida CA, "Practice parameters for the indications for polysomnography and related procedures : an update for 2005", Sleep, 28, pp.499~521 (2005)[DOI]