Yee Brendon, Liu Peter, Phillips Craig, Grunstein Ron
Woolcock Institute of Medical Research, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
Curr Opin Pulm Med. 2004 Nov;10(6):475-81. doi: 10.1097/01.mcp.0000143967.34079.27.
To review recent investigations examining the effects of neuroendocrine changes in obstructive sleep apnea.
Gonadal hormones have long been implicated in the pathogenesis of obstructive sleep apnea. Recently, exogenous testosterone has been shown to exacerbate obstructive sleep apnea, whereas hormone replacement therapy in menopausal women may be protective in obstructive sleep apnea. Effective treatment of obstructive sleep apnea with nasal continuous positive airway pressure has been associated with improved insulin sensitivity and testicular function in individuals with obstructive sleep apnea.
It is important to consider the potential development of sleep apnea in any patient who has an endocrine disorder or is receiving certain hormonal therapies. Effective assessment and management of obstructive sleep apnea with nasal continuous positive airway pressure may lead to a reduction in insulin resistance and hypertension as well as other markers of vascular risk in patients with metabolic syndrome.
回顾近期关于阻塞性睡眠呼吸暂停中神经内分泌变化影响的研究。
长期以来，性腺激素一直被认为与阻塞性睡眠呼吸暂停的发病机制有关。最近的研究表明，外源性睾酮会加重阻塞性睡眠呼吸暂停，而绝经后女性的激素替代疗法可能对阻塞性睡眠呼吸暂停具有保护作用。使用鼻持续气道正压通气有效治疗阻塞性睡眠呼吸暂停与改善阻塞性睡眠呼吸暂停患者的胰岛素敏感性和睾丸功能有关。
对于任何患有内分泌疾病或正在接受某些激素治疗的患者，都应考虑睡眠呼吸暂停的潜在发展。使用鼻持续气道正压通气对阻塞性睡眠呼吸暂停进行有效的评估和管理，可能会降低代谢综合征患者的胰岛素抵抗和高血压以及其他血管风险指标。
