睡眠和呼吸道感染
Ignacio Boira1, Eusebi Chiner1
1Sleep Unit, Pneumology Department, San Juan de Alicante University Hospital, Alicante, Spain.
Seminars in respiratory and critical care medicine
|February 3, 2025
概括
睡眠呼吸障碍 (SDB),就像阻塞性睡眠呼吸暂停 (OSA),会增加炎症并增加呼吸道感染的风险. 在呼吸系统患者中,早期的SDB查对于预防并发症至关重要.
科学领域:
- 睡眠医学 睡眠医学
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 睡眠障碍,包括昼夜节律障碍和睡眠呼吸障碍 (SDB),如阻塞性睡眠呼吸暂停 (OSA),越来越多地被认为与呼吸道感染有关.
- SDB通过间歇性缺氧,睡眠碎片化,氧化压力和高水平的炎症调解剂 (TNF,IL-6,CRP) 促成炎症状态,其水平通常与SDB严重程度相关,特别是在OSA患者中.
- 相关因素如夜间微吸,胃食道逆流和并发症 (例如肥胖) 进一步增加了肺炎,病毒感染 (包括SARS-CoV-2) 和其他呼吸道并发症的风险.
研究的目的:
- 探索睡眠障碍,特别是SDB和OSA之间的复杂关系,以及它们对呼吸道感染易感性和结果的影响.
- 突出SDB促进炎症并增加各种呼吸道感染和并发症的风险的机制.
- 强调在患有呼吸道感染的患者中考虑SDB的重要性,以减轻潜在的不良事件.
主要方法:
- 文献综述和对睡眠障碍,SDB,OSA和呼吸道感染现有研究的综合.
- 分析SDB,炎症和免疫反应之间的病理生理联系.
- 检查流行病学数据和临床观察,将睡眠障碍与感染风险和结果联系起来.
主要成果:
- 包括OSA在内的SDB与炎症状态密切相关,增加了对呼吸道感染的易感性,如社区获得的肺炎和病毒感染 (例如,SARS-CoV-2).
- OSA与术后并发症和COVID后综合征的增加有关,而支气管切除症等慢性疾病可能会加剧OSA风险.
- 虽然睡眠障碍治疗对感染的保护作用仍在调查中,但SDB是呼吸道并发症的重要危险因素.
结论:
- 睡眠呼吸障碍显著导致炎症,并增加呼吸道感染和相关并发症的风险.
- 在患有呼吸道感染的患者中,对SDB的查对于及时管理和预防严重结果至关重要.
- 需要进一步的研究来阐明睡眠障碍治疗在减轻呼吸道感染风险方面的保护作用.
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