Dobrosielski Devon A, Papandreou Christopher, Patil Susheel P, Salas-Salvadó Jordi
Dept of Kinesiology, Towson University, Towson, MD, USA
Both authors contributed equally.
Eur Respir Rev. 2017 Jun 28;26(144). doi: 10.1183/16000617.0110-2016. Print 2017 Jun 30.
Obstructive sleep apnoea (OSA) is associated with increased cardiovascular disease (CVD) morbidity and mortality. It is accepted that OSA and obesity commonly coexist. The American Academy of Sleep Medicine recommends dietary-induced weight loss and exercise as lifestyle treatment options for OSA. However, most clinical trials upon which this recommendation is based have focused on establishing the effectiveness of calorie-restricted, often low-fat diets for improving OSA severity, whereas less attention has been given to the means through which weight loss is achieved ( altered dietary quality) or whether diet or exercise mediates the associations between reduced weight, improved OSA severity and the CVD substrate. The current evidence suggests that the benefits of a low-carbohydrate or Mediterranean diet in overweight and obese individuals go beyond the recognised benefits of weight reduction. In addition, exercise has an independent protective effect on vascular health, which may counter the increased oxidative stress, inflammation and sympathetic activation that occur in OSA patients. This review aims to expand our understanding of the effects of diet and exercise on OSA and associated CVD complications, and sets the stage for continued research designed to explore optimal lifestyle strategies for reducing the CVD burden in OSA patients.
阻塞性睡眠呼吸暂停（OSA）与心血管疾病（CVD）的发病率和死亡率增加有关。人们普遍认为OSA与肥胖常常并存。美国睡眠医学学会推荐通过饮食诱导减重和运动作为OSA的生活方式治疗选择。然而，该推荐所基于的大多数临床试验都集中在确定限制热量摄入（通常是低脂饮食）对改善OSA严重程度的有效性上，而对于实现减重的方式（改变饮食质量）或饮食或运动是否介导了体重减轻、OSA严重程度改善与CVD底物之间的关联关注较少。目前的证据表明，低碳水化合物饮食或地中海饮食对超重和肥胖个体的益处超出了公认的减重益处。此外，运动对血管健康具有独立的保护作用，这可能抵消OSA患者中发生的氧化应激、炎症和交感神经激活增加。本综述旨在扩展我们对饮食和运动对OSA及相关CVD并发症影响的理解，并为继续开展旨在探索减轻OSA患者CVD负担的最佳生活方式策略的研究奠定基础。
