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Obstrukční340900029817231641850559773486496711071171
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apnoe26299000298127269409546672
MUDr.3401290013793168245287311
Martin6731290013793152194236267332
Pretl,10271290013764105163204235264
CSc.13141290013765125174204
Neurologická3401450013372128188223283309369431456505556609
ambulance9731450013353144206266291344404453507
a15031450013353
spánková15791450013344105159219270328380433
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s.2972145001334366
r.3052145001333654
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spánkové6861600013344105158219270328380433
medicíny,11431600013391147209234283308368418435
Praha1601160001335993146206259
Obstrukční3402110012169127166200233289335379434458
spánková826211001214096145201247301349397
apnoe12512110012149106162217268
(OSA)1547211001212995144204232
je1807211001212475
chronické19102110012145100133188243267312358407
onemocnění,23462110012155111161245300346401452508531552
jehož2926211001212475131186228
výskyt3183211001214899138185236272
v34832110012149
populaci35532110012157113171226340225001212473119142
je511225001212576
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mezi9622250012185136180204
511962250012152
až1277225001214993
1013992250012152100
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Vzhledem16602250012157100157181232291342427
k21162250012148
výskytu21862250012149101141189240277333
i25482250012124
zdravotním25942250012144101135184232287320377400485
důsledkům31082250012158113153177229287335391476
patří36132250012158108141174198
mezi3402390012184135178202
nejvýznamnější5712390012155106130179230276332380464519570594634657
poruchy12572390012157113146202247303349
spánku1634239001214097146202249305
a19672390012149
bdění.20372390012157115166222245266
Neosvěživý23322390012166117173213262311355378427478
fragmentovaný2839239001212963112168252303359391446493542598644
spánek3511239001214097146202253300
kvůli340253001214798154177200
repetitivním558253001213383140191224247280303352408431514
respiračním1090253001213383122179202235283328383406489
událostem15982530012155111159183238277311360444
vede2060253001214897155205
k22832530012147
celé2351253001214594118168
řadě2537253001213381138188
denních27432530012157107163218241286341
příznaků3102253001215789113156211259306361
výrazně3481253001214899133181224280330
ovlivňujících3402670012156104128152201258314338362407431476532
kvalitu9012670012148100149173197231287
života.1217267001214367116171205254276
Mezi15222670012182133178202
hlavní1753267001215680129176233257
rizikové2039267001213357101125173227275325
faktory2393267001213080128164219253304
patří27262670012158108141174198
nadváha29532670012156105163212262318367
s33492670012140
obezitou,34112670012155113165210234267322379400
mužské3402810012182136178218263311
pohlaví6682810012156111165188235280303
a9882810012148
střední1056281001213972103152208262284
a13572810012147
vyšší1424281001214897136174196
věk.1637281001214795141163
OSA18172810012168115174
je2008281001212473
spojována2098281001213994149171225271319373419
především2534281001215688137193242288327349431
s29822810012139
kardiovaskulárními3041281001214694126180203257303350388434488510557589643666747770
a3402950012148
metabolickými4092950012183133166214271326350373417463513597619
(hlavně1046295001212883106154200256306
diabetes1369295001215679127183234267316355
mellitus17412950012183133157180203235290329
2.2087295001215172
typu)2177295001213382140195220
chorobami.24142950012145100154187241298346429452472
Neléčená29042950012165115139189234283338386
OSA33072950012169117176
zvyšuje3501295001214293143182236260310
u3403090012155
kardiovaskulárních415309001214695127182205259305353391437492515562594649671715769
chorob1202309001214498152185238295
riziko151430900121325597120166219
morbidity17503090012183137170226249305327360409
a21763090012148
mortality.22443090012182137169204252275298330379395
OSA26563090012169116175
je2849309001212473
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rizikovým341330900121325597120166219265315398
faktorem340323001212978125161215248298381
pro747323001215790144
rozvoj917323001213387129180234258
inzulinové1201323001212378121176200223278333380429
rezistence,1656323001213383126149189222272327372421441
glukózové2123323001215679134181235276331378427
intolerance2576323001212479111165189240272321376421470
a30723230012148
DM2,31413230012167147198218
zvyšuje3385323001214394144184238262312
riziko3723323001213356340337001214366113167
vzniku526337001214893149172219274
cévních820337001214594141197221265320
mozkových11603370012183139180227281328379423478
příhod1658337001215789113170225282
a19603370012148
dopravních20303370012156111168201250296352376420475
nehod.25253370012156106162217274295
U28403370012165
většiny2926337001214897130171194249294
pacientů32403370012157106151174224279312367
není36263370012156106162185
OSA3403510012169117177
diagnostikována535351001215780127183239294333367390436490537585641689
(801242351001212877129
%13893510012179
případů).1486351001215790113170219275330355374
Úspěšný18783510012164103159210249304350
screening2246351001213984117167217273296351407
umožňuje26713510012155139194236291346369420
vyhledat3109351001214898154178228285333366
rizikové349335100121325699122168222269318
pacienty.3403650012157105150173223278310360376
Kromě734365001215487142225275
nutného10273650012155110143198248303358
povědomí14033650012157112159208265320403426
o18473650012155
chorobě1923365001214499154187241298348
jsou2289365001212463118173
k24803650012147
dispozici2548365001215679118174230271294339362
validované2928365001214796119142198253300348403453
dotazníky33993650012156111144192235291314362412
(STOP-Bang)340379001212875126193247277333382437493520
a8803790012148
screeningové949379001214085117167218274297352408463510560
metody.15293790012183134167221278326342
Diagnóza1892379001216690138194249304346396
je2308379001212474
stanovována2403379001213973122177232279333380429484532
hlavně2955379001215679127174230280
pomocí32553790012157113197252297320
polygrafického35953790012157113137185340393001215587135164189234279328383437
eventuálně794393001215097145200232286333356411460
polysomnografického12723930012156111135182221275358412467523555602631657701746795850904
vyšetření.2193393001214898137187219251300355378398
Základní26083930012155104150174222278332355
volbou29803930012148101124180235290
léčby3287393001212373118174219
střední3524393001213972104153210264287
a3404070012148
těžké409407001213383126173222
OSA6554070012169117177
je856407001212475
terapie955407001213382115164220244294
přetlakem1273407001215790140173196244291340423
v17214070012148
dýchacích17904070012156104148203251296318363418
cestách2232407001214594134167216261316
(PAP).2572407001212981136189215233
Při2829407001215485109
pravidelném2962407001215790138185209265315339395445529
užívání3515407001215598121169218273296
byl3404210012157103127
prokázán489421001215790144191241284334389
protektivní899421001215790145178227274310333381437461
efekt1381421001215080130177213
léčby1615421001212474120176223
PAP18594210012153108161
na20414210012156104
celkovou2166421001214594118164218265319374
i25614210012124
kardiovaskulární2606421001214796129185208263310359398444500523571604659683
mortalitu.33104210012183138171207256279302336390411
Klíčová340437001246292121167226279333
slova:701437001244473133186240267
obstrukční9964380012156114154189223279327371428452
spánková1477438001214098148204252307355405
apnoe19114380012149107163220272
(OSA),2212438001212997146208236255
kvalita24964380012148100150174198232281
života,2807438001214367117172205255277
kardiovaskulární3113438001214898132189213269317367407455511535584618675699
a3404520012148
metabolické4094520012184134168217273329353376421467516
choroby,9464520012145100155188243300346362
screening,1330452001213984117166217273296351408428
polygrafie,17794520012157113137185240272321350376426446
přetlak2246452001215790140173197245291
v25584520012149
dýchacích26284520012156104148203251295318363418
cestách3067452001214594134167216261316
(PAP).3404452001212981136189215233
Obstructive3404790012472133176214253311357396425478530
sleep890479001244372125179240
apnea11504790012453113173226280
Obstructive3404970012168125163196228283327361384431479
sleep836497001214062112162218
apnea10714970012147103158207255
(OSA)1343497001212893141200227
is1587497001212361
a16654970012148
chronic1733497001214499130184239261305
disease2055497001215678117166213252301
with2373497001217396128183
a25734970012147
prevalence2641497001215688137184231254304358402451
in3109497001212377
the3203497001213387136
population33564970012157112168222245292324346400455
estimated340511001215089122145228275307356413
between7705110012157107141216265315371
511585110012151
%12215110012179
and13175110012148103159
101494511001215197
%.16035110012179101
Due17215110012166122171
to1910511001213386
its201451100121235696
occurrence2128511001215499143197229262311366411459
and26055110012148102159
medical27815110012183133190213257305328
consequences,3127511001214498153192242298353402458502551590610
it3755511001212356
ranks340525001213381136183226
among5845250012148131186242298
the900525001213388139
most10575250012183139178212
significant1287525001213962118173197226252297346401433
sleep1738525001214063113164222
disorders.1978525001215679118173206263313346386408
Non-restorative24045250012165121177209243292332366420453501534557605654
fragmented3076525001213063112167251301357389438496
sleep3590525001213963113164221
caused340539001214593148187238295
by6585390012157104
repetitive785539001213383140191224247280303352401
respiratory1209539001213383122178202234283315369402453
events1685539001215098147203235275
leads1984539001212374122178218
to2225539001213387
a23355390012149
wide2405539001217497154204
range2633539001213281136192243
of2899539001215584
daytime30065390012157105150187210293343
symptoms3373539001213987171228261315399438
that340553001213388136169
significantly534553001213962118173196226252297345401433456504
affect1063553001214877109160205241
quality13295530012156111159182205238288
of1642553001215584
life.175155300121244776126146
The19225530012150106157
main21045530012183131154209
risk233855300121335796142
factors2505553001212978123158212245286
include2816553001212378123146201258308
overweight31495530012155102151184260310333389445477
and36515530012148103160
obesity,3405670012155112163202225258308324
male6885670012183131155205
gender,9165670012156106162219269302318
and12575670012148104160
middle14415670012183106163219243293
to1757567001213488
older1868567001215579135186219
age.21105670012148104154174
OSA23085670012169117177
is2508567001212463
primarily2594567001215790114197245277301324371
associated2989567001214887126181227250298330380437
with3449567001217497131186
cardiovascular3658567001214593126340581001215680135182230269314369393441473
and8405810012148104160
metabolic10275810012183134167216273329353376421
diseases1474581001215780119170218257307347
(especially1848581001212875114171222268291338362385432
type2307581001213383141192
225265810012151
diabetes2604581001215680128184235269318357
mellitus).29885810012184134158181204237292332356375
Untreated33905810012165119152184234282315364421
OSA3405950012169117177
increases542595001212479124156206254293344383
the950595001213489139
risk111459500121335796142
of1281595001215584
morbidity13905950012184139172229253309332366415
and18305950012149104161
mortality20165950012183138171207256279302335385
in2426595001212479
cardiovascular2530595001214594126182205260308356395440495518566599
diseases.3154595001215680119169217256307346368
OSA35475950012169117177
is3749595001212363
an3406090012148103
independent464609001212479136186243294350406457512545
risk103060900121325695142
factor1192609001213079123159213246
for1459609001212984117
the1597609001213388138
development17566090012157107154204228283340423474530562
of2339609001215584
insulin2444609001212378117172195218273
resistance,2738609001213383122145184218267322367416436
glucose3195609001215679134179233272322
intolerance,3538609001212479111165189240340623001213381136181230250
and6136230012148103160
type796623001213383140191
210106230012151
diabetes;1084623001215679127184235268318357377
it1483623001212457
increases1562623001212479124156206254293344383
the1968623001213388139
risk212962300121335695142
of2294623001215584
stroke2400623001214074106161208257
and26806230012148103160
traffic2862623001213466115144176202247
accidents.3132623001214893136159216266322354395416
In3571623001212479
the3673623001213388138
majority3406370012183131155210243267300350
of709637001215584
patients,8136370012156105138161211267299340361
OSA11936370012169117177
is1390637001212362
undiagnosed14726370012155110167190238294349404444494551
(802043637001212878130
%21856370012179
of2284637001215584
cases).2387637001214594133183223248266
Successful26736370012149103148192241281320350406429
screening3122637001213984117167218273296352408
allows354963700121487295150223262
identification340651001212379129184215238267293337385417439494549
of906651001215483
at-risk1006651001214880108141164203249
patients.12726510012156104136159208263295335356
In1645651001212479
addition17416510012148104160182215238292347
to2105651001213386
the2209651001213287137
necessary23636510012155105150198237276324356406
awareness27866510012148119167199248303353392430
of3234651001215483
the3334651001213387137
disease,3488651001215679117167215253303322
validated340665001214895118141196243275324380
questionnaires7376650012156110159198231254308363417464487519568606
(STOP-Bang)1361665001212874123190242272327375429484511
and18896650012148102158
screening2064665001213983115164214269292346401
methods24826650012183132165220274330369
are2868665001214779128
available.3013665001214894141164187234290313363382
Diagnosis3412665001216689136191246300339361399
is340679001212363
mainly4316790012183131155210233281
established740679001215090123172229253276315371421478
through1247679001213388120175230287342
polygraphic16176790012157113137184240272321378434457502
or2147679001215588
polysomnographic22636790012157113137184224279363418473530563611668724747792
examination.3083679001215098146229252308356388411466522543
The36546790012150107157
primary340693001215790113196245277327
treatment695693001213365115163196279329385417
choice11406930012145100155178223272
for1439693001212984117
moderate15846930012183138195246279327360409
and20206930012148104160
severe2208693001213990137186219269
OSA25046930012169118178
is2709693001212362
positive27996930012157113152175208231279328
airway3155693001214871103180228274
pressure3456693001215790140179218273305355
(PAP)340707001212881136188214
therapy.572707001213388138171219275322338
Regular9287070012153104160215238286318
use1264707001215594145
of1426707001215584
PAP15287070012153108161
therapy1706707001213388139171220276322
has20467070012155103142
been22067070012157108158214
shown2438707001213994149222278
to2733707001213387
have28387070012155103149198
a30547070012148
protective3124707001215790144177226271307329378426
effect3568707001215080112162208243
on3407210012155111
overall4727210012155102151184232256279
and7727210012148104160
cardiovascular953721001214594126183206261308356396441495519567599
mortality.15747210012183138171207256279302335385402
Key3407370012460111161
words:5177370012475131168227270296
obstructive8297380012154110148181213267311345367414462
sleep1308738001213961111160216
apnea15417380012147103157206253
(OSA),1811738001212893140199226243
quality20717380012156109156179201233281
of2369738001215483
life,246873800121244674123142
cardiovascular2627738001214492123178200254300347386429483506552584
and32287380012147101156
metabolic34017380012182132164212267322345367411
diseases,340752001215680119169217256307346367
screening,729752001213984117166217273296351407428
polygraphy,11787520012157113137185240272321377433479495
positive16947520012157113152175208231279329
airway2044752001214871103180228274
pressure2339752001215790140179218273305355
(PAP).2715752001212981136189215233
DECLARATIONS:4068213008648871301662142563043393604124625014570213008514
Declaration406822700874987120141179207245272292334376
of445822700874166
originality:45382270087406888131151193231252272299338358
The406823800853473109
manuscript418823800855791130168195227249266306329
is452823800851644
original45832380085386178117133172205222
and481623800853472112
has49392380085387299
not50502380085387699
been516123800853975110149
published532123800854078118135151178217252292
or406824900853862
submitted414524900852867108167184208234269310
elsewhere.44702490085355381117169209246269305320
Ethical406826300873764107127160198219
principles43012630087427090132165185229249288319
compliance:463526300873172134177198218256298331369388
The406827400853678116
authors420527400853475100142183208238
attest44642740085356087124154179
that466427400852465101126
their481127400852465103121146
study49782740085295596138173
was517327400855389118
approved531327400853477119144185220257300
by406828500854073
the41582850085236399
local42742850085165689124141
Ethical44322850085345898115147182199
Committee464828500854179139198215239265300337
and500128500853474114
is513228500851745
in519428500851656
compliance526628500853270130170188205239279311347
with40682960085537298140
human423629600854081143180221
studies44862960085285496139157195226
and474029600853577119
animal48882960085347695156193212
welfare512829600855391110133170196233
regulations53902960085236110414516420140683070085234080120148
of423630700853859
the43153070085236399
authors’44343070085347397136176200229244
institutions46983070085175684109126150189214231270310338
as505630700853462
well513830700855187105122
as528030700853362
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