Studying The End Event Of CPAP Therapy On Moderate-severe OSAHS Combining Cerebrovascular Disease

Obstructive sleep apnea syndrome and stroke in patients have quite high concurrent rate,and both have very complicated reciprocal causation-the actual, the interaction mechanism. Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common sleep disorder for sleep, characterized by recurring completely and (or) not completely blocked, accompanied by intermittent hypoxemia, hypercapnia, sleep structure disorder, and may cause organism multiple viscera function damaged. The international most scholars think that OSAHS is defined as When is sleepping, nose and mouth airflow suspended over 10s, and hypoventilation is nose and mouth flow intensity decreased 50% continue more than 10s and with oxygen desaturation to more than 4%, and sleep apnea hypopnea syndrom is apnea times greater than or equal to 30 times in seven hours of sleep or apnea hyponea index (AHI) greater than or equal to 5 times/h. OSAHS for stroke is a basic, independent risk factor, in sleep it is easy to happen ischaemic stroke. The possible mechanism for OSAHS leading to stroke occurrence and development is sleep apnea, and frequent airway obstruction can lead to hypoxia, hypercapnia, thoracic cavity negative pressure and repeatedly awakening thus cause sympathetic reaction activation, hemodynamics, and coagulation system abnormalities and vascular injury. Both at home and abroad have data shows that OSAHS is closely related with cerebrovascular diseases, and if serious OSAHS patients is left untreated, long-dated fatality rate increase, so they shuold be timely and effectively treatmented.The treatment aim is to control sleep disorder, correct low oxygen state and resuming the continuity. At present the nasal mask continuous positive airway pressure (CPAP) is effective treatment method of moderate- severe OSAHS and can make patients function residual capacity(FRC) increase, reduce airway resistance and increase the airway tension, prevent airway to collapse and make patients airway open on, so this can reduce or eliminate patients apnea and snore happen and restore normal sleep structure and improve the night sleep oxygen,and rise blood oxygen saturation, to control or ease the occurrence of sleep apnea and snoring, thus improve the quality of life, relieve symptoms. CPAP therapy has been proved to be the most effective approach to correct OSAHS.This is an open, compared, parallel experiment,to explore fixed level pressure of CPAP on cerebrovascular event secondary prevention.There are 29 patients of the age of 45-75 years old, once with stroke or transient ischemic attack (TIA) combining with the moderate-severe obstructive sleep apnea hypopnea syndrome (OSAHS) , randomized to access group (CPAP + routine therapy) and control group (conventional therapy). and there is a clinical observation of the CPAP group through the week-long AUTO - CPAP model of pressure titration.And the titration objective is to determine an optimal pressure to eliminate apnea, low ventilation, and the snoring, and breathing continuous, and to prevent micro awakening to ensure in all sleep phase the airway and postures open , so that determining the appropriate treatment ventilation,and then take the pressure for treatment with a year follow-up.The purpose of this study is to determine whether long-term use of CPAP can reduce the incidence of cerebrovascular event of patients with OSAHS combining with cerebrovascular disease, namely,to observe the end event rate of both groups, blood lipid and blood sugar ,glycosylated hemoglobin, weight, blood pressure, snoring frequency, and apnea hypoventilation index (AHI) neck circumference and waist, hip circumference, sleepiness scale and anxiety depression scale and adverse events or not and so on.To assessment clinical benefit of CPAP in ischemic cerebrovascular event.This study focuses on observation apnea hypoventilation index (AHI), sleepiness scale score and the destination event.The result show: Because the cases are too few, and observation time is not long enough, endpoint event rate statistics is limited, in the control group a patient atrial fibrillation happening and which by medications have been controled. The rest of the patients, all did not happen obvious adverse events. Patients apnea hypopnea index(AHI): the CPAP group improved obviously, and control group increased. The Epworth sleepiness scale score: patients of CPAP group reduced significantly, and patients of the controlgroupincreased.Therefore, we can see that OSAHS patients breathe disorders and sleep disorders are reversible, and CPAP is the best treatment.