Pharmacy Practice Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI 53705, USA.
Nutr Clin Pract. 2009 Dec;24(6):675-87. doi: 10.1177/0884533609351532.
Sleep-disordered breathing (SDB) is a medical condition that has increasingly recognized adverse health effects. Obesity is the primary risk factor for the development of SDB and contributes to cardiovascular and metabolic abnormalities in this population. However, accumulating evidence suggests that SDB may be related to the development of these abnormalities independent of obesity. Periodic apneas and hypopneas during sleep result in intermittent hypoxemia, arousals, and sleep disturbances. These pathophysiologic characteristics of SDB are likely mechanisms underlying cardiovascular and metabolic abnormalities including hypertension and other cardiovascular diseases, altered adipokines, inflammatory cytokines, insulin resistance, and glucose intolerance. Treatment of SDB with continuous positive airway pressure reverses some but not all of these abnormalities; however, studies to date have demonstrated inconsistent findings. Weight loss strategies, including diet, exercise, medications, and bariatric surgery, have been evaluated as a treatment strategy for SDB. In preliminary studies, dietary intervention and exercise reduced severity of SDB. One study demonstrated improvements in SDB severity using the weight-reducing medication sibutramine. In morbidly obese subjects, bariatric surgery effectively induces weight loss and improvement in SDB severity and symptoms, but long-term benefits remain uncertain. Large randomized trials are required to determine the utility of these strategies as long-term approaches to improving SDB and reducing associated complications.
睡眠呼吸障碍（SDB）是一种日益被认识到的对健康有不良影响的医学病症。肥胖是 SDB 发展的主要危险因素，并导致该人群出现心血管和代谢异常。然而，越来越多的证据表明，SDB 可能与这些异常的发生有关，而与肥胖无关。睡眠期间周期性的呼吸暂停和低通气导致间歇性低氧血症、觉醒和睡眠障碍。SDB 的这些病理生理特征可能是导致心血管和代谢异常的机制，包括高血压和其他心血管疾病、脂肪因子改变、炎症细胞因子、胰岛素抵抗和葡萄糖耐量异常。持续气道正压通气治疗 SDB 可逆转其中一些但不是全部异常；然而，迄今为止的研究结果存在不一致。减重策略，包括饮食、运动、药物和减重手术，已被评估为 SDB 的治疗策略。在初步研究中，饮食干预和运动降低了 SDB 的严重程度。一项研究表明，使用减重药物西布曲明可改善 SDB 严重程度。在病态肥胖患者中，减重手术可有效诱导体重减轻和 SDB 严重程度和症状改善，但长期获益仍不确定。需要进行大型随机试验来确定这些策略作为改善 SDB 和减少相关并发症的长期方法的效用。
