ACİL SERVİSTE FARKINDALIĞI ARTAN BİR TANI: OBSTRÜKTİF UYKU APNE SENDROMU A Diagnosis With Increased Awareness in Emergency Service: Obstructive Sleep Apnea Syndrome

Öz

ÖZET

Obstrüktif uyku apne sendromu (OUAS), uykuda başlayan ve tekrarlayan üst solunum yolu obstrüksiyonları

ve beraberinde oksijen satürasyonunda azalmalar ile karakterize bir hastalıktır.

Buna bağlı olarak gelişen serebral disfonksiyon ile gündüz uyku hali ve konsantrasyon eksikliği

görülür. Yapılan çalışmalarda, tedavi edilmemiş uyku bozukluklarının, kardiyovasküler hastalıklar,

ani ölüm, inme ve metabolik ve nörokognitif bozukluklar ve trafik kazaları ile ilişkili olduğu görülmüştür.

Uyku bozuklukları, morbidite ve mortalitenin önemli bir nedeni olarak giderek daha

fazla önem kazanmaktadır. Bu nedenle, tedavi edilmemiş uyku bozukluklarının varlığı hem kişi,

hem de toplum hayatını olumsuz yönde etkilemektedir. Hastalığın erken tanınması ve uygun tedavi

için yönlendirilmesi açısından acil servislerde çalışan hekimler kritik bir role sahiplerdir. Bu

derlemede; uyku apnesinin birçok hastalığa neden olarak acil servise başvuru nedeni olabileceği

ve acil servise ani ölümle gelen hastalarda tanı ve ayırıcı tanıda uyku apnesinin düşünülmesinin

gerektiği vurgulanmaya çalışılmıştır.

Anahtar Sözcükler: Obstrüktif uyku apnesi sendromu; Acil servis; Ani kardiyak ölüm

ABSTRACT

Obstructive sleep apnea syndrome (OSAS) is a disease characterized by sleep-onset and recurrent

upper respiratory obstructions and concomitant decreases in oxygen saturation. As a result,

daytime drowsiness and concentration deficits are seen with developing cerebral dysfunction.

Studies have shown that untreated sleep disorders are associated with cardiovascular disease,

sudden death, stroke, and metabolic and neurocognitive disorders and traffic accidents. Sleep

disturbances are becoming increasingly important as a crucial cause of morbidity and mortality.

For this reason, the presence of untreated sleep disorders affects both personal and community

life negatively. Emergency service physicians have a critical role in the early recognition of the

disease and the orientation to appropriate treatment. In this review; it was tried to emphasize

that sleep apnea can cause many illness as emergency service admission reason, and the

necessity of considering sleep apnea in the diagnosis and the differential diagnosis of the

patients with sudden death in the emergency service.

Keywords: Obstuctive sleep apnea syndrome; OSAS; Emergency service; Sudden cardiac death.

Anahtar Kelimeler

• ACİL SERVİSTE FARKINDALIĞI ARTAN BİR TANI: OBSTRÜKTİF UYKU APNE SENDROMU A Diagnosis With Increased Awareness in Emergency Service: Obstructive Sleep Apnea Syndrome

Kaynakça

1. 1. Demir AU. “Obstruktif uyku apne sendromu (OUAS) ve obezite”. Hacettepe Tıp Dergisi 2007; 38:177-193 2. Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical Guideline for the Evaluation, Management and Long-term Care of Obstructive Sleep Apnea in Adults. Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine. 2009;5(3):263-276. 3. Bauters F, Rietzschel ER, Hertegonne KB, Chirinos JA (2016) The link between obstructive sleep apnea and cardiovascular disease. Curr Atheroscler Rep 18:1. 4. Mansukhani, Meghna P., Shihan Wang, and Virend K. Somers. “Sleep, death, and the heart.” American Journal of Physiology-Heart and Circulatory Physiology 309.5 (2015): H739-H749. 5. Mehta, Vishisht, et al. “Is obstructive sleep apnea more common in adults with arrhythmias?.” Lung India: official organ of Indian Chest Society 33.5 (2016): 575. 6. Fisser, Christoph, et al. “Association of sleep-disordered breathing and disturbed cardiac repolarization in patients with ST-segment elevation myocardial infarction.” Sleep Medicine 33 (2017): 61-67. 7. Bilal, Nagihan, et al. “Obstructive sleep apnea is associated with increased QT corrected interval dispersion: the effects of continuous positive airway pressure.” Brazilian Journal of Otorhinolaryngology (2017). 8. Pedrosa, Rodrigo P., et al. “Obstructive Sleep Apnea.” Hypertension 58.5 (2011): 811-817. 9. Marin, José M., et al. “Association between treated and untreated obstructive sleep apnea and risk of hypertension.” Jama 307.20 (2012): 2169-2176. 10. Gami, Apoor S., et al. “Obstructive sleep apnea and the risk of sudden cardiac death: a longitudinal study of 10,701 adults.” Journal of the American College of Cardiology 62.7 (2013): 610-616.