臨床検査68巻9号

2024年09月発行

今月の特集 知っておきたい睡眠時無呼吸症候群

閉塞性睡眠時無呼吸の治療

著者： 西島嗣生¹ 峯田武典¹ 山口貴之¹

所属機関： ¹岩手医科大学睡眠医療学科

ページ範囲：P.1053 - P.1059

Point

●無呼吸低呼吸が1時間に20回以上ある閉塞性睡眠時無呼吸（OSA）の第一選択治療は持続的陽圧呼吸（CPAP）である．

●口腔内装置（OA）の治療適応は軽症〜中等症の閉塞性無呼吸に使用されるが，CPAP治療より劣る．

●上下顎骨同時前方移動術（MMA）の適応は中等症〜重症のCPAP療法に不耐のOSAにおける第二段階の手術であり，口蓋垂軟口蓋咽頭形成術（UPPP）を含む第一段階手術の効果が十分に得られない例に推奨されている．

●減量・代謝改善手術（MS）は，6カ月以上の内科的治療によっても十分な効果が得られない体容積指数（BMI）が35以上の肥満症の患者であって，糖尿病，高血圧症，脂質異常症またはOSAのうち1つ以上を合併している方に適応となる．

●植込み型舌下神経刺激療法は，CPAP療法に不耐のOSAにおける新規治療である．

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