Ott Sebastian Robert, Korostovtseva Lyudmila, Schmidt Markus, Horvath Thomas, Brill Anne-Kathrin, Bassetti Claudio L
Department of Pulmonary Medicine, University Hospital (Inselspital) and University Bern, Switzerland; Interdisciplinary Sleep Wake Centre (SWEZ), University Hospital (Inselspital) and University Bern, Switzerland.
b Interdisciplinary Sleep Wake Centre (SWEZ), University Hospital (Inselspital) and University Bern, Switzerland; V.A. Almazov Federal North-West Medical Research Centre, St Petersburg, Russia.
Swiss Med Wkly. 2017 May 22;147:w14436. doi: 10.4414/smw.2017.14436. eCollection 2017.
In recent decades, the association between sleep-disordered breathing (SDB) and cardio- and cerebrovascular diseases (including hypertension, coronary heart disease and stroke) has been the focus of interest of both clinicians and researchers. A growing concern is the increasing prevalence of SDB in the general population, which can be partly explained by the rise in obesity prevalence and population aging, as well as by the development of enhanced diagnostic tools and approaches. Because of evidence of adverse long-term effects of SDB on cardiovascular morbidity and overall mortality, systematic screening for SDB should be considered for populations at risk. The evidence of a long-term benefit of treatment for SDB, however, is still controversial and the best management approaches are still unclear. This article summarises available epidemiological data and focuses on the main pathophysiological mechanisms linking SDB to cardio- and cerebrovascular disorders. We will also give a critical overview of the current diagnostic procedures. The available treatment approaches and their prognostic effects on cardio- and cerebrovascular health will be discussed in a second paper.
近几十年来,睡眠呼吸紊乱(SDB)与心脑血管疾病(包括高血压、冠心病和中风)之间的关联一直是临床医生和研究人员关注的焦点。一个日益受到关注的问题是,SDB在普通人群中的患病率不断上升,这部分可以归因于肥胖患病率的上升、人口老龄化,以及诊断工具和方法的改进。由于有证据表明SDB对心血管疾病发病率和总体死亡率有长期不良影响,因此应考虑对高危人群进行SDB的系统筛查。然而,SDB治疗的长期益处的证据仍存在争议,最佳管理方法也尚不清楚。本文总结了现有的流行病学数据,并重点关注将SDB与心脑血管疾病联系起来的主要病理生理机制。我们还将对当前的诊断程序进行批判性概述。关于现有治疗方法及其对心脑血管健康的预后影响将在第二篇论文中进行讨论。