Igor Fajdiga1
Patofiziologija obstruktivne apneje
v spanju – hipoteza
Obstructive Sleep Apnea Pathophysiology – Hypothesis
iZvleČek
KLJUČNE BESEDE: dihanje, ovirana dihalna pot, hipokapnija, hipoksemija, nadzor dihanja
IZHODIŠČA. Obstruktivna apneja v spanju je klinično dobro opredeljena motnja dihanja,
za katero se povečuje zanimanje v zadnjih desetletjih. Patofiziologija motnje – vpliv ovi-
ranega dihanja na nastanek zastojev dihanja in na povezane srčno-žilne ter presnovne
motnje – ni povsem jasna. METODE. Za razjasnitev obstruktivne apneje v spanju smo
analizirali zapise poligrafije, opravljene s sistemom ApneaGraph® pri dvajsetih osebah
z znano obstruktivno apnejo v spanju in pri štirih z neoviranim dihanjem. Spreminjanje
tlaka v požiralniku, nasičenost arterijske krvi s kisikom in hitrost pretoka zraka med diha-
njem v spanju smo analizirali z znanimi fizikalnimi in fiziološkimi principi. REZULTATI
in RAZPRAVA. Rezultati prikazujejo obstruktivno apnejo v spanju kot prilagoditev diha-
nja na sočasno in vztrajno nižanje ravni kisika in ogljikovega dioksida v krvi, ki je posle-
dica ovirane ventilacije in nizkega metaboličnega ustvarjanja ogljikovega dioksida med
spanjem. 
aBstraCt
KEY WORDS: breathing, airway obstruction, hypocapnia, hypoxemia, breathing control
BACKGROUNDS. Obstructive sleep apnea is a clinically well-defined disorder gaining
growing interest in recent decades. Its pathophysiology and the relationship between upper
airway obstruction, breathing stops during sleep, and consequent comorbidities are not
entirely understood. METHODS. To clarify obstructive sleep apnea, we analyzed poly-
graphic recordings performed with the ApneaGraph® system in twenty persons with con-
firmed obstructive sleep apnea and four with unobstructed breathing. The dynamics of
esophageal pressure, oxygen hemoglobin saturation, and airflow velocity were analyzed
with physical and physiological principles. RESULTS and DISCUSSION. The results sug-
gest a sequence of causally related events that present obstructive sleep apnea breathing
as a respiratory adjustment to simultaneous and persistently increasing hypocapnia and
hypoxemia, which is a consequence of obstructed ventilation and low metabolic carbon
dioxide production in sleeping.
1 Dr. Igor Fajdiga, dr. med., Klinika za otorinolaringologijo in cervikofacialno kirurgijo, Univerzitetni klinični center
Ljubljana, Zaloška cesta 2, 1000 Ljubljana; igor.fajdiga@guest.arnes.si
373Med Razgl. 2022; 61 Suppl 2: 373
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