Respiratory 4000 Medicine, -Apr. 000, 2005 1 135 2 14 Key Words : sleep apnea syndrome, management, CPAP, surgical treatment, children sleep disordered breathing SDB SDB sleep apnea-hypopnea syndromesassahs 4 SDB nasal continuous positive airway pressurencpap SDB SAS SDB SDB obstructive sleep apnea-hypopnea syndromeosahssas SDB OSAHS 1 Non-surgical and surgical managements for sleep disordered breathing. 1 Nobuo OHYA, M.D., Ph.D. & Tomoko SAKURAI, M.D., Ph.D.: 0020-0034 9-52; Senior Clinical Researchers, The Seimindo Sleep Lab Systems, Morioka 020-0034, JAPAN 2 Shigeru SAKURAI, M.D., Ph.D.: 3 4 5
2 1 2 OSAHSrisk factor 3 SDB 4 OSAHS 5 OSAHSindependent risk factor 67 8 9 SAS OSAHS ncpap 10 11 ncpap 12 OSAHS 7 13 ncpap 7 4 14 central sleep apneahypopnea syndromecsahs CO2CO2 CO2 kyphoscoliosis COPD 2 CO2 OSAHS REM CO2 Cheyne-Stokes CSR 1 crescendo-decrescendo45 15 CSR 16 CPAP CPAPLVEF Naughton 17 3 CPAP 1212 CPAPLVEF CPAPCSR 18
Respiratory Medicine, Apr. 2005 3 n p 19 0.7l CSR CPAPCSR CSR CSR CPAP CSR UARS OSAHS UARS respiratory effort related arousalsrera ncpap
4 SAS polysomnographypsg SDB PSG SAS bed partner 20 7 4 43cm 21 SDB body mass index28kg/m 2 OSA OSA75 22 500 23 PSG PSG SAS SAS SAS apnea
Respiratory Medicine, Apr. 2005 5 hypopnea indexahi SASAHI 5 14 86 AHI15 308085 AHI3079 24 PSGCPAP PSGSAS SDB 25 AHI2040 8 AHI 5 1CPAP CPAPSAS 1 ncpap CPAP ResMed CPAP 26 PSG PSG 6 CPAP 1 split-night protocol 27 2 8 PSG. CPAP A12 B123 11 40 2 11 20 2 3
6 2004 4 1 26 AHI20 RERACPAP AHI40 CPAP PSG CPAP CPAP 50 2 4 28 29 1 CPAP CPAP nasal pillow 7 4 C-flex Respironics 600
Respiratory Medicine, Apr. 2005 7 ResMed 30 SASCPAP NPPV CSA 2 CPAP CPAP AHICPAP oral applianceoamandibular advancement CPAP CPAP 31 AHI 32 PSG PSG 33 3 34 SAS10 SAS 35 PSG
8 CPAP orthopharyngeal maxillofacial PSG 1 UPPP LAUP RFA UPPP 854050SAS 50 36 80 1 UPPP 2LAUP LAUPOSAHS LAUPUPPP 8090 37 OSAHS4050 38 3RFA RFALAUP 4maxillofacial surgery maxillomandibular advancement surgery 7 4 90 100 39 maxillomandibular advancement surgery 5 CPAP SAS SAS CPAP OSAS ADHD 40
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