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Yıl:2015; Cilt: 2; Sayı: 1>> Özet
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Türk Uyku Tıbbı Dergisi; 2015;2(1):20-21
Ağır Obstrüktif Uyku Apnesi Sendromlu Bir Olguda Klostrofobi ve Uykuda Ölüm Korkusuna Bağlı Yaşanan Tedaviye Uyum Sorununun Çözümü
A Erkoç, S Kayhan, Ü Şahin
Recep Tayyip Üniversitesi, Rize
Obstrüktif uyku apnesi sendromu (OUAS) kişinin yaşam kalitesini etkileyen ve psikososyal sorunlarla önemli derecede ilişkili olduğu düşünülen bir uyku bozukluğudur. OUAS’ın en özgün ve etkin sağaltımı, CPAP (sürekli pozitif hava yolu basıncı) tedavisidir. Bu nedenle hastaların tedaviye uyumu büyük önem taşımaktadır. Olgu sunumu, CPAP cihazına uyum açısından OUAS’lı hastanın hastalıkla ilgili farkındalığının sağlanması ve tedaviye uyumu teşvik edici olumlu destekte bulunulmasının etkinliğini irdelemek amacıyla hazırlanmıştır. OUAS teşhisi konulan olgu, maske ve CPAP cihazını kullanmakta sorunlar yaşaması üzerine kapalı alan fobisi (klostrofobi) ve uykuda ölüm korkusu yaşadığı saptandı. Psikiyatri hekimliğince essitalopram başlandı. CPAP tedavisi, CPAP cihazının ve maskelerinin kullanımı ve tedaviye uyumun semptom kontrolündeki olumlu etkileri konusunda hastaya ayrıntılı eğitim verildi. Eğitim desteği ile birlikte uygulanan medikal tedavi sonrasında; hastanın anksiyete düzeyi düşürüldü ve OUAS ile ilgili farkındalık sağlanarak CPAP uyumunda artış gözlendi. CPAP tedavisi önerilen ağır OUAS’lı olgunun sağaltımında; hastanın psikolojik durumunun değerlendirilmesinin yanında hastalıkla ilgili farkındalığının sağlanması ve tedaviye uyumu teşvik edici olumlu destekte bulunulmasının etkinliği gösterilmiştir. Bu bağlamda, hasta eğitimi ve desteklenmesi açısında kapsamlı araştırmaların planlanmasını önermekteyiz.
Management of Compliance Problem Due to Fear of Death While Sleeping andClaustrophobia in a Patient with Severe Obstructive Sleep Apnea Syndrome
As a sleep disorder obstructive sleep apnea syndrome (OSAS) is considered to be significantly associated with psychosocial problems and affects the quality of life. The most original and effective treatment of OSAS is continuos positive airway pressure treatment. Therefore the compliance of patients to treatment is very important. This case report has been prepared in order to examine the effectiveness that providing awareness of patient with OSAS and providing positive support forencouraging the compliance of the patient to treatment. Our patient with OSAS has some problems about using mask and CPAP and we determined that the patient has fear of death while sleeping and claustrophobia. Psychiatry clinic recommended the use of escitalopram. A detailed information was explained to the patient about CPAP treatment, using of mask, positive effects on symptom control and the meaning of compliance. After the implementation of train and medical treatment; the patient’s anxiety level was reduced and awareness about obstructive sleep apnea syndrome and a high compliance of CPAP treatment were obtained. We provided an awareness of OSAS and positive support to encouraging compliance of patient to treatment by evaluating the psychological state of the patient. In this context, we recommend the planning of comprehensive research in terms of patient training and support to patient.

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