Jen Rachel, Grandner Michael A, Malhotra Atul
Respiratory Division, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Division of Pulmonary and Critical Care, University of California, San Diego, La Jolla, California, USA.
Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Can J Cardiol. 2015 Jul;31(7):880-8. doi: 10.1016/j.cjca.2015.02.007. Epub 2015 Feb 14.
Sleep disordered breathing (SDB) is highly prevalent among patients with cardiovascular disease (CVD), and the relationship between SDB and CVD may be bidirectional. However, SDB remains underdiagnosed and undertreated. One of the major barriers identified by cardiologists is lack of satisfaction with SDB therapy. This situation could be the result of the discordance between treatment and the pathophysiological characteristics of SDB. This condition is caused by multiple pathophysiological mechanisms, which could be classified into upper airway anatomic compromise, pharyngeal dilator muscle dysfunction, and ventilatory control instability. However, the effective treatment of SDB remains limited, and positive airway pressure therapy is still the mainstay of the treatment. Therefore, we review the pathophysiological characteristics of SDB in this article, and we propose to provide individualized treatment of SDB based on the underlying mechanism. This approach requires further study but could potentially improve adherence and success of therapy.
睡眠呼吸紊乱（SDB）在心血管疾病（CVD）患者中极为普遍，且SDB与CVD之间的关系可能是双向的。然而，SDB仍然诊断不足且治疗不充分。心脏病专家指出的主要障碍之一是对SDB治疗不满意。这种情况可能是治疗与SDB病理生理特征不一致的结果。这种状况由多种病理生理机制引起，可分为上气道解剖结构受损、咽部扩张肌功能障碍和通气控制不稳定。然而，SDB的有效治疗仍然有限，气道正压通气治疗仍是主要治疗方法。因此，我们在本文中综述了SDB的病理生理特征，并建议根据潜在机制对SDB进行个体化治疗。这种方法需要进一步研究，但可能会提高治疗的依从性和成功率。
