臨床検査58巻3号

2014年03月発行

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今月の特集2 知っておくべき睡眠呼吸障害のあれこれ

睡眠呼吸障害の治療

著者： 西坂麻里¹² 安藤眞一¹

所属機関： ¹九州大学病院　睡眠時無呼吸センター ²九州大学大学院医学研究院　循環器内科

ページ範囲：P.373 - P.382

●睡眠呼吸障害（SDB）の多様な病態や，循環器疾患や生活習慣病との関連が知られるようになってきた．

●SDBのパターン，特性を踏まえたテーラーメイド治療が必要である．

●適切な治療とその継続には背景疾患の把握が必須である．

●解剖学的特性，人種差を踏まえた，わが国独自の治療ガイドラインが必要である．

参考文献

1）百村伸一，赤柴恒人，麻野井英次，他：循環器病の診断と治療に関するガイドライン（2008-2009年度合同研究班報告）循環器領域における睡眠呼吸障害の診断・治療に関するガイドライン．Circulation Journal（1346-9843）　74（suppl Ⅱ）：963-1051，2010

2）American Academy of Sleep Medicine：International classification of sleep disorders, 2nd ed, American Academy of Sleep Medicine, Westcheter，2005

3）Morgenthaler TI, Kagramanov V, Hanak V, et al：Complex sleep apnea syndrome: is it a unique clinical syndrome? Sleep　29：1203-1209，2006

4）Ando S, Ishitobi Y, Yagi T, et al：Prevalence of complex sleep apnea syndrome in Japan. Sleep Biol Rhythms　6：190-192，2008

5）Bradley TD, Hall MJ, Ando S, et al：Hemodynamic effects of simulated obstructive apneas in humans with and without heart failure. Chest　119：1827-1835，2001

6）Akashiba T, Minemura H, Yamamoto H, et al：Effects of nasal continuous positive airway pressure on pulmonary haemodynamics and tissue oxygenation in patients with obstructive sleep apnoea. Respirology　4：83-87，1999

7）Bradley TD, Logan AG, Kimoff RJ, et al：Continuous positive airway pressure for central sleep apnea and heart failure. N Engl J Med　353：2025-2033，2005

8）Arzt M, Floras JS, Logan AG, et al：Suppression of central sleep apnea by continuous positive airway pressure and transplant-free survival in heart failure: a post hoc analysis of the Canadian Continuous Positive Airway Pressure for Patients with Central Sleep Apnea and Heart Failure Trial (CANPAP). Circulation　115：3173-3180，2007

9）Sullivan CE, Issa FG, Berthon-Jones M, et al：Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. Lancet　1：862-865，1981

10）徳永豊：臨床医が語るCPAP療法のディテール（第1回）　医療機器としてのCPAPとその仕組み．睡眠医療　5：83-89，2011

11）Naughton MT, Rahman MA, Hara K, et al：Effect of continuous positive airway pressure on intrathoracic and left ventricular transmural pressures in patients with congestive heart failure. Circulation　91：1725-1731，1995

12）Zozula R, Rosen R：Compliance with continuous positive airway pressure therapy: assessing and improving treatment outcomes. Curr Opin Pulm Med　7：391-398，2001

13）Bradley TD, Holloway RM, McLaughlin PR, et al：Cardiac output response to continuous positive airway pressure in congestive heart failure. Am Rev Respir Dis　145（2 Pt 1）：377-382，1992

14）Yoshida M, Kadokami T, Momii H, et al：Enhancement of cardiac performance by bilevel positive airway pressure ventilation in heart failure. J Card Fail　18：912-918，2012

15）Haruki N, Takeuchi M, Kaku K, et al：Comparison of acute and chronic impact of adaptive servoventilation on left chamber geometry and function in patients with chronic heart failure. Eur J Heart Fail　13：1140-1146，2011

16）Yoshihisa A, Suzuki S, Miyata M, et al：‘A single night’ beneficial effects of adaptive servo-ventilation on cardiac overload, sympathetic nervous activity, and myocardial damage in patients with chronic heart failure and sleep-disordered breathing. Circ J　76：2153-2158，2012

17）Yoshihisa A, Suzuki S, Owada T, et al：Short-term use of adaptive servo ventilation improves renal function in heart failure patients with sleep-disordered breathing. Heart Vessels　28：728-734，2013

18）Koyama T, Watanabe H, Terada S, et al：Adaptive servo-ventilation improves renal function in patients with heart failure. Respir Med　105：1946-1953，2011

19）Koyama T, Watanabe H, Igarashi G, et al：Effect of short-duration adaptive servo-ventilation therapy on cardiac function in patients with heart failure. Circ J　76：2606-2613，2012

20）Kasai T, Usui Y, Yoshioka T, et al：Effect of flow-triggered adaptive servo-ventilation compared with continuous positive airway pressure in patients with chronic heart failure with coexisting obstructive sleep apnea and Cheyne-Stokes respiration. Circ Heart Fail　3：140-148，2010

21）Koyama T, Watanabe H, Igarashi G, et al：Short-term prognosis of adaptive servo-ventilation therapy in patients with heart failure. Circ J　75：710-712，2011

22）西坂麻里，安藤眞一：循環器疾患と睡眠呼吸障害　新たな治療戦略ASVの意義とは．循環制御　33：150-163，2012

23）Kushida CA, Morgenthaler TI, Littner MR, et al：Practice parameters for the treatment of snoring and Obstructive Sleep Apnea with oral appliances: an update for 2005. Sleep　29：240-243，2006

24）Blanco J, Zamarrón C, Abeleira Pazos MT, et al：Prospective evaluation of an oral appliance in the treatment of obstructive sleep apnea syndrome. Sleep Breath　9：20-25，2005

25）Mehta A, Qian J, Petocz P, et al：A randomized, controlled study of a mandibular advancement splint for obstructive sleep apnea. Am J Respir Crit Care Med　163：1457-1461，2001

26）Gotsopoulos H, Chen C, Qian J, et al：Oral appliance therapy improves symptoms in obstructive sleep apnea: a randomized, controlled trial. Am J Respir Crit Care Med　166：743-748，2002

27）Barnes M, McEvoy RD, Banks S, et al：Efficacy of positive airway pressure and oral appliance in mild to moderate obstructive sleep apnea. Am J Respir Crit Care Med　170：656-664，2004

28）Hoffstein V：Review of oral appliances for treatment of sleep-disordered breathing. Sleep Breath　11：1-22，2007

29）Randerath WJ, Heise M, Hinz R, et al：An individually adjustable oral appliance vs continuous positive airway pressure in mild-to-moderate obstructive sleep apnea syndrome. Chest　122：569-575，2002

30）Engleman HM, McDonald JP, Graham D, et al：Randomized crossover trial of two treatments for sleep apnea/hypopnea syndrome: continuous positive airway pressure and mandibular repositioning splint. Am J Respir Crit Care Med　166：855-859，2002

31）Lam B, Sam K, Mok WY, et al：Randomised study of three non-surgical treatments in mild to moderate obstructive sleep apnoea. Thorax　62：354-359，2007

32）Fritsch KM, Iseli A, Russi EW, et al：Side effects of mandibular advancement devices for sleep apnea treatment. Am J Respir Crit Care Med　164：813-818，2001