Teschler H, Randerath W
Ruhrlandklinik, Abteilung Pneumologie, Westdeutsches Lungenzentrum, Universitätsklinikum Essen, Essen.
Pneumologie. 2010 Sep;64(9):583-9. doi: 10.1055/s-0030-1255677. Epub 2010 Sep 8.
Sleep-related breathing disorders are common adult illnesses in Western countries and classified as either dominant obstructive sleep apnoea or dominant central sleep apnoea. Cheyne-Stokes Respiration is part of the spectrum of CSA. The earliest descriptions of patients who presumably suffered from sleep apnoea were made in the 19th century. The term ''Pickwickian'' in connection with sleepy patients was introduced in 1889. The first electrophysiological sleep recordings of Pickwickian patients and the understanding of the syndrome as disordered breathing in sleep, were made during the late 1950s and 1960s at the universities of Heidelberg and Freiburg in Germany. The term sleep apnoea syndrome was introduced by Guilleminault from Stanford. The introduction of continuous positive airway pressure (CPAP) therapy by C. E. Sullivan and co-workers gave an enormous impetus to the field of sleep-disordered breathing. Its recognition as a public health problem was facilitated by the Wisconsin study, investigating the prevalence of sleep apnoea in the middle-aged general population. Nowadays obstructive sleep apnoea (OSA) is recognised as an independent risk factor for a wide range of clinical conditions, such as atherosclerosis, hypertension, heart failure, arrhythmias, stroke, diabetes, and depression. This article focuses on issues related to OSA and CSA/CSR, their pathogenesis, interaction with other comorbidities including cardiovascular diseases. Future research will focus on treatment effects on cardiovascular and metabolic outcomes in sleep apnoea and on the pathophysiological mechanisms responsible for the inflammatory state and cardiovascular morbidity in the syndrome. Other potential areas of research include biochemical markers, new diagnostic and therapeutic modalities.
睡眠相关呼吸障碍是西方国家常见的成人疾病，可分为主要的阻塞性睡眠呼吸暂停或主要的中枢性睡眠呼吸暂停。陈-施呼吸是中枢性睡眠呼吸暂停谱的一部分。最早对疑似患有睡眠呼吸暂停患者的描述可追溯到19世纪。1889年引入了与嗜睡患者相关的“匹克威克式”一词。20世纪50年代末和60年代，德国海德堡大学和弗莱堡大学对匹克威克式患者进行了首次睡眠电生理记录，并将该综合征理解为睡眠中的呼吸紊乱。“睡眠呼吸暂停综合征”一词由斯坦福大学的纪尧姆诺尔特提出。C. E. 沙利文及其同事引入的持续气道正压通气（CPAP）疗法极大地推动了睡眠呼吸障碍领域的发展。威斯康星州的一项研究调查了中年普通人群中睡眠呼吸暂停的患病率，这有助于将其认定为一个公共卫生问题。如今，阻塞性睡眠呼吸暂停（OSA）被认为是多种临床疾病的独立危险因素，如动脉粥样硬化、高血压、心力衰竭、心律失常、中风、糖尿病和抑郁症。本文重点关注与OSA和CSA/CSR相关的问题、它们的发病机制、与包括心血管疾病在内的其他合并症的相互作用。未来的研究将集中在睡眠呼吸暂停对心血管和代谢结局的治疗效果以及该综合征中炎症状态和心血管发病率的病理生理机制。其他潜在的研究领域包括生化标志物、新的诊断和治疗方法。
