UYKU APNE SENDROMU İLE GEÇİRİLMİŞ KAFA TRAVMASI İLİŞKİSİ

Yıl 2010, Cilt: 24 Sayı: 2, 101 - 111, 01.10.2010

Zeynep Zeren Ucar Serhan Olcay Ahmet Ugur Demir Sami Cenk Kıraklı Zeynep Munteha Şevket Dereli Rıfat Özacar

Öz

Uykuda solunum bozukluğu gelişiminin kafa travması geçiren hastalarda arttığı bildirilmiştir, ancak aralarındaki ilişki tam aydınlatılamamıştır. Çalışmamızda uyku apne sendromu ile kafa travması arasındaki ilişkiyi araştırmak amaçlanmıştır. Kafa travması ve trafik kazası öyküsü, uyku apne sendromu ön tanısı ile polisomnografi yapılan 564 hastadan, çalışmaya katılmayı kabul eden 334 hastada (katılım oranı: %59), telefonda uygulanan anket formu ile sorgulandı. Hastaların 263'ünde (%78.7) obstrüktif uyku apne sendromu (OUAS), 12'sinde (%3.6) santral uyku apne sendromu (SUAS) mevcuttu. Kafa travması, kafa ve boyunda yaralanma, servikal herni, trafik kazası sırasıyla 93 (%27.8), 40 (%12.0), 35 (%10.5), 82 (%24.6) hastada bildirildi. Lineer regresyon modelinde yaş, cinsiyet, BKİ kontrol edildiğinde, servikal herni, obstrüktif AHİ ile (beta-12.8, %95 GA: -22.5, -3.2); BKİ hariç etkenler kontrol edildi ğinde sürücüyken trafik kazası öyküsü, santral AHİ ile (beta: 4.8, %95GA: 1.4, 8.1) ilişkili bulundu. Bu çalışmada uyku apne sendromu ön tanısı ile uyku laboratuarında yatan hasta topluluğunda genel populasyona göre daha fazla oranda minörmaj ör kafa travması ve trafik kazası geçirme öyküsü saptanmıştır. Ayrıca santral tip uyku apne sendromunun daha önce geçirilmiş kafa travması ile ilişkili ortaya çıkabileceği, obstrüktif tip uyku apne sendromunun ise hastalığa bağlı olarak trafik kazası ve kafa travmasını artırdığını düşündürmüştür. Servikal herni ise üst solunum yolunda oluşan değişikliklerle OUAS için koruyucu olabileceğini düşündürmüştür.

Anahtar Kelimeler

Uyku apne sendromu, kafa travması, trafik kazası

THE ASSOCIATION BETWEEN SLEEP APNEA SYNDROME AND HEAD TRAUMA

Öz

Increased occurrence of sleep related breathing disorder has been reported in patients with head trauma, but the association has not been elucidated. This study was aimed to investigate the association between sleep apnea syndrome and head trauma. Of the 564 patients, who had polysomnography with a preliminary diagnosis of sleep apnea, 334 (participation rate: 59%) gave consent and had telephone administered survey, which included information on history of head trauma and traffic accident. Obstructive sleep apnea syndrome (OSAS) and central sleep apnea syndrome (CSAS) were present in 263 (78.7%) and 12 (3.6%) patients, respectively. Head trauma, head and neck injury, neck hernia and traffic accident were reported in 93 (27.8%), 40 (12.0%), 35 (10.5%), 82 (24.6%) patients, respectively. Linear regression analysis adjusting for age, gender and BMI found association of cervical hernia with obstructive AHI (beta-12.8, 95% CI: -22.5, -3.2); and traffic accident as a driver w ith central AHI (beta: 4.8, 95% CI: 1.4, 8.1) adjusted for the factors except BMI. Higher rate of minor- major head trauma and traffic accident were reported in the population who were admitted to sleep disorders laboratory with a suspicion of OSAS than the general population in this study. Moreover CSAS could be associated with previous brain injury due to head trauma and OSAS could increase the prevalence of traffic accidents and head trauma due to disease. Cervical hernia related upper airway changes could be protective for OSAS.

Anahtar Kelimeler

Sleep apnea syndrome, head trauma, traffic accident

Kaynakça

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