阻害性睡眠無呼吸症とその心血管への影響
T Douglas Bradley1, John S Floras
1Sleep Research Laboratory of the Toronto Rehabilitation Institute, Toronto, Canada.
Lancet (London, England)
|December 23, 2008
まとめ
阻害性睡眠無呼吸 (OSA) は,心臓血管の健康に重大な影響を及ぼし,高血圧や心不全などの疾患のリスクを高めます. OSAの治療はこれらのリスクを軽減する可能性があるが,改善された心血管疾患のアウトカムを確認するために大規模な試験が必要である.
科学分野:
- 心臓病学 心臓病学
- スリープ・メディシン (睡眠医学)
- 内科内科は,内科の内科である.
背景:
- 阻害性睡眠時無呼吸症 (OSA) は,睡眠中に繰り返される呼吸停止を伴う.
- これらの出来事は,低酸素,負の胸内圧,および興奮を引き起こし,心臓血管系にストレスを与える.
- OSAは,高血圧,冠動脈疾患,心不全,脳卒中のリスクの増加と関連しています.
研究 の 目的:
- 阻害性睡眠無呼吸症の心血管への影響を検討する.
- 心血管の健康に対するOSA治療の潜在的な利点の評価をするために.
- さらに大規模な臨床試験の必要性を特定する.
主な方法:
- OSAと心血管疾患に関する疫学研究のレビュー.
- OSAに対する継続的な陽性気道圧 (CPAP) 治療を調査するランダム化試験からのデータの分析.
- OSAと心血管疾患を結びつける病理生理学的メカニズムに関する現在の証拠の統合.
主要な成果:
- OSAは,低酸素,交感活性化,炎症を含む有害な心血管刺激を誘発する.
- CPAPによる治療は,心不全患者の血圧の低下や心機能の改善などの利点を示しています.
- 流行病学的データは,OSAと主要な心血管疾患を強く関連付けています.
結論:
- 阻害性睡眠無呼吸症は,心血管疾患の重要な危険因子です.
- OSAの治療,特にCPAPによる治療は,心血管疾患のリスクを軽減することに有望であることが示されています.
- さらに大規模なランダム化試験は,OSA治療が心血管疾患のアウトカムを改善するかどうかを決定的に確立するために不可欠です.
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