O'Halloran Ken D
Department of Physiology, School of Medicine, University College Cork, Cork, Ireland.
Respir Physiol Neurobiol. 2016 Jun;226:63-7. doi: 10.1016/j.resp.2015.10.013. Epub 2015 Oct 31.
Obstructive sleep apnoea syndrome (OSAS) is a common respiratory disorder with devastating consequences for integrative body systems. A picture is emerging to illustrate wide-ranging deleterious consequences of disordered breathing during sleep for major homeostatic control systems, with considerable interest in cardiorespiratory and autonomic morbidity underpinning the development of hypertension. The vista is bleak when one also considers the link between OSAS and a host of other maladies. Exposure to chronic intermittent hypoxia (CIH), resulting from repeated obstructions of the pharyngeal airway, is a hallmark feature of OSAS that appears, in animal models, to drive the development and maintenance of several key morbidities. A growing body of evidence now points to aberrant respiratory plasticity at multiple levels following exposure to CIH. Herein, we review the experimental data revealing that CIH causes: respiratory muscle weakness and fatigue; impaired motor control of the upper airway; and, discordant respiratory rhythm and pattern generation. This multifaceted conspiracy creates the perfect storm with the potential to exacerbate OSAS-serving to establish an inescapable cycle of respiratory morbidity. Several pharmacological interventions in animal models appear wholly effective in preventing the calamitous consequences of CIH and may have application as adjunctive therapies in the treatment of OSAS.
阻塞性睡眠呼吸暂停综合征（OSAS）是一种常见的呼吸系统疾病，会对人体整体系统造成严重后果。一幅图景正在浮现，以说明睡眠期间呼吸紊乱对主要稳态控制系统产生的广泛有害影响，人们对心肺和自主神经疾病相当关注，这些疾病是高血压发展的基础。当人们还考虑到OSAS与许多其他疾病之间的联系时，前景不容乐观。由于咽部气道反复阻塞导致的慢性间歇性缺氧（CIH）暴露是OSAS的一个标志性特征，在动物模型中，它似乎推动了几种关键疾病的发展和维持。现在越来越多的证据表明，暴露于CIH后，多个层面会出现异常的呼吸可塑性。在此，我们回顾实验数据，这些数据表明CIH会导致：呼吸肌无力和疲劳；上气道运动控制受损；以及不协调的呼吸节律和模式产生。这种多方面的协同作用形成了一场完美风暴，有可能加剧OSAS，从而建立一个无法逃避的呼吸疾病循环。动物模型中的几种药物干预措施似乎在预防CIH的灾难性后果方面完全有效，可能作为辅助疗法应用于OSAS的治疗。
