Uykuda Solunum Bozukluklarında Polisomnografi Dışı Tanısal Yöntemler
Özet
Obstrüktif Uyku Apnesi (OUA), uykuda tekrarlayan solunum durmaları ve oksijen düşüşleriyle seyreden, yüksek prevalanslı ancak sıklıkla gözden kaçan bir hastalıktır. Tedavi edilmediğinde hipertansiyon, kardiyak aritmi, inme ve trafik kazaları gibi ciddi mortalite ve morbidite risklerine yol açmaktadır. Hastalığın teşhisinde altın standart yöntem laboratuvar ortamında uygulanan polisomnografidir (PSG). Ancak PSG; zaman alıcı olması, özel ekipman ve yetişmiş personel gerektirmesi nedeniyle yüksek maliyetli bir süreçtir. Bu nedenle, uyku laboratuvarına sevk edilecek doğru hastaların seçilmesi büyük önem taşır. Bu amaçla klinik pratikte, hekimlerin ortak bir dille hastaları değerlendirmesini sağlayan çeşitli uluslararası anket ve ölçekler geliştirilmiştir. Gündüz uykululuk seviyesini ölçen Epworth Uykuluk Ölçeği, toplum taramalarında sıkça başvurulan Berlin Anketi, preoperatif risk analizi için tasarlanan STOP ve STOP-BANG anketleri ile boyun çevresi ve obezite gibi parametreleri puanlayan NoSAS ve GOAL ölçekleri bu yöntemlerin başında gelir. Bu tarama araçları, riskli bireyleri etkili bir şekilde belirleyerek uyku uzmanlarına ve klinisyenlere hasta seçiminde rehberlik etmektedir.
Obstructive Sleep Apnea (OSA) is a highly prevalent yet frequently overlooked sleep-related respiratory disorder characterized by recurrent upper airway obstructions and drops in blood oxygen levels during sleep. Left untreated, OSA is strongly associated with severe complications, including hypertension, cardiac arrhythmia, stroke, and an increased risk of traffic accidents. Polysomnography (PSG) remains the gold standard diagnostic method for assessing the severity of the disease through the Apnea-Hypopnea Index (AHI). However, since PSG is a time-consuming procedure requiring overnight laboratory stays, specialized equipment, and trained technicians, the appropriate selection of candidates for this study is critical. To optimize this process and facilitate a standardized clinical approach, several internationally recognized questionnaires and screening scales have been developed. Key instruments include the Epworth Sleepiness Scale for evaluating daytime sleepiness, the Berlin Questionnaire for population screening, and the STOP/STOP-BANG tools for assessing preoperative risks. Additionally, multi-parametric scoring models like NoSAS and GOAL leverage risk factors such as neck circumference, obesity, age, and gender to effectively identify high-risk individuals, providing vital guidance for clinicians in patient prioritization.
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