Peker Yüksel, Grote Ludger, Kraiczi Holger, Hedner Jan
Sömnlaboratoriet, avdelningen för lungmedicin och allergologi, Sahlgrenska Universitetssjukhuset, Göteborg.
Lakartidningen. 2002 Nov 7;99(45):4473-9.
Obstructive sleep apnea (OSA) affects almost one fifth of the male and 10% of the female middle-aged population. Only one fifth of subjects with more or less severe disorder of breathing report simultaneous daytime sleepiness. There is growing research evidence for an independent association between OSA and cardiovascular disease (CVD). The suggestion that this link is not only correlative but also causative is strongly supported by a series of recent clinical and epidemiological studies. The association between OSA and traditionally recognized cardiovascular risk factors suggests that OSA may provide an additive and synergistic risk in cases with co-existing obesity, insulin resistance, diabetes and/or dyslipidaemia. These recent insights advocate better awareness of OSA and potentially also a wider use of screening-tools for early identification and treatment of sleep related breathing disorders. Moreover, current research within the fields of obesity and cardiovascular prevention needs to identify OSA as a study confounder. Continuous intense research into pathophysiological mechanisms and therapeutic possibilities of CVD related to OSA appears to be an important and potentially rewarding area of disease prevention.
阻塞性睡眠呼吸暂停（OSA）影响着近五分之一的中年男性和10%的中年女性。只有五分之一患有或多或少严重呼吸障碍的受试者报告同时存在日间嗜睡。越来越多的研究证据表明OSA与心血管疾病（CVD）之间存在独立关联。一系列近期的临床和流行病学研究有力地支持了这种联系不仅是相关性的，而且是因果性的这一观点。OSA与传统上公认的心血管危险因素之间的关联表明，在同时存在肥胖、胰岛素抵抗、糖尿病和/或血脂异常的情况下，OSA可能会增加风险并产生协同作用。这些最新见解提倡提高对OSA的认识，并可能更广泛地使用筛查工具，以早期识别和治疗与睡眠相关的呼吸障碍。此外，肥胖和心血管疾病预防领域目前的研究需要将OSA识别为一个研究混杂因素。对与OSA相关的CVD的病理生理机制和治疗可能性进行持续深入的研究，似乎是疾病预防的一个重要且可能有回报的领域。
