2 Sindromul de

apnee in somn

1
Plasma Vascular Endothelial Growth Factor
in OSAS. Lavie L AJRCCM 2002

VEGF levels were reduced by CPAP therapy

 Enhanced superoxide release from
neutrophils in OSAS. Shulz, AJRCCM 2000.

Superoxide release in OSA vs healthy volunteers and non-apnoeic

controls and impact of CPAP therapy.
 SCOR MALLAMPATI

Class I: soft palate, fauces, uvula,

pillars
Class II: soft palate, fauces, portion
of uvula
Class III: soft palate, base of uvula
Class IV: hard palate only 

Liistro G, Eur Respir J 2003

 Scorul Epworth

• Notati care sunt sansele de a atipi in situatiile de

mai jos, folosind urmatoarea scala pentru a
alege cel mai potrivit numar pentru fiecare
situatie:
• 0 - nici o sansa de atipire
• 1 - sanse slabe de atipire
• 2 - sanse moderate de atipire
• 3 - sanse mari de atipire
 Scala de somnolenta Epworth

SITUATIA 0 1 2 3

Stand si citind

Privind la televizor

Stand inactiv intr-un loc public

Ca pasager intr-o masina pentru cel putin o ora fara pauza

Stand intins dupa-amiaza, atunci cand conditiile o permit

Stand si vorbind cu cineva

Stand linistit dupa un pranz fara alcool

In masina, oprita pentru cateva minute in trafic

MORFOTIPUL

Schwab et al – AJCCM, 1995

 Jean-Louis Pépin
Laboratoire du Sommeil
CHU GRENOBLE
 Non-CPAP therapies
Selection of patients
Lee C. et al. Arch Otolaryngol 2010;136:677-81
POLIGRAFIA

• Fluxul de aer
• Microfon traheal

• Centura toracica
• Centura abdominala
• Puls-oximetru

Spitalul Clinic de Pneumologie Iasi – D.Boisteanu

Sustained attention: Driving
simulator test
Lateral deviation in road position following
7.5 hr TIB
Lateral deviation in road position following
4.5 hr TIB
Lateral deviation in road position following
4.5 hr TIB, with 300mg slow-release caffeine
 Tratamentul SAO

NON - CHIRURGICAL
CHIRURGICAL – Tracheostomie
– Scadere – UPPP
ponderala – Chirurgia
– CPAP nasului
– Terapie – Suspensie
pozitionala hiomandibulara
– Dispozitive orale – Avansare
– Medicamente mandibulara
Tratamentul SAO

- forme usoare: masuri generale

- forme medii sau severe: CPAP cu masca
nazala/facial
- sforait cu intensitate inalta (80-100dB) care
interfera cu calitatea somnului - CPAP
Scadere ponderala
Terapia pozitionala
Dispozitive orale

Heinzer

Esmarch

Spitalul Clinic de Pneumologie Iasi – D.Boisteanu

INSUFLATION OF AIR WITH POSITIVE PRESSURE ON A NASAL MASK MENTAINS
THE PERMEABILITY OF THE NOSE AND THROAT DURING SLEEP
Masti