Obstruktif Uyku Apne Sendromu Tanı Kriterleri ve Klinik Özellikleri
Özet
Obstrüktif uyku apne sendromu (OUAS), uyku sırasında tekrarlayan üst solunum yolu tıkanıklıkları, kan oksijen satürasyonunda düşüş ve arousal ile karakterize, mortalitesi yüksek önemli bir halk sağlığı sorunudur. Prevalansı dünya genelinde %9 ile %38 arasında değişmekte olup obezite, yaş ve erkek cinsiyet en önemli risk faktörleridir. Yetişkinlerde 40-65 yaş arasında pik yapan sendrom, çocuklarda ise sıklıkla adenotonsiller hipertrofi nedeniyle 2-8 yaşlarında görülür. Horlama, tanıklı apne ve gündüz aşırı uyku hali hastalığın majör semptomları arasında yer alırken, tanı kriterleri klinik semptomlar ile polisomnografi veya taşınabilir cihazlarla yapılan testlerdeki solunumsal olay sayılarına dayanır. Fizik muayenede üst solunum yolu anatomisi ve Mallampati skorlaması kritik öneme sahiptir. Tedavi yaklaşımlarını belirleyen standart parametre ise hafif, orta ve ağır olarak sınıflandırılan Apne Hipopne İndeksi'dir (AHİ). OUAS; hipertansiyon, diyabet ve inme gibi kardiyovasküler ve metabolik hastalıklarla yakın ilişkilidir. Bu nedenle, şüpheli olguların hayat kalitesini artırmak ve mortaliteyi azaltmak adına multidisipliner bir yaklaşımla değerlendirilmesi ve vakit kaybetmeden uyku laboratuvarına yönlendirilmesi gerekmektedir.
Obstructive sleep apnea syndrome (OSAS) is a major public health problem with high mortality, characterized by recurrent upper airway obstructions during sleep, a decrease in blood oxygen saturation, and arousals. Its prevalence varies between 9% and 38% globally, with obesity, age, and male gender being the most significant risk factors. The syndrome peaks between the ages of 40-65 in adults, whereas in children, it occurs between 2-8 years, mostly due to adenotonsillar hypertrophy. Snoring, witnessed apnea, and excessive daytime sleepiness are among the major symptoms, while diagnostic criteria are based on clinical symptoms and the number of respiratory events in sleep tests performed with polysomnography or portable devices. Upper airway anatomy and Mallampati scoring are of critical importance in physical examination. The standard parameter determining treatment approaches is the Apnea-Hypopnea Index (AHI), which is classified as mild, moderate, and severe. OSAS is closely associated with cardiovascular and metabolic diseases such as hypertension, diabetes, and stroke. Therefore, to improve the quality of life and reduce mortality, suspected cases must be evaluated with a multidisciplinary approach and referred to a sleep laboratory without delay.
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