Hamilton Garun S, Joosten Simon A
Aust Fam Physician. 2017;46(7):460-463.
Obstructive sleep apnoea (OSA) and obesity are two common conditions affecting the Australian population; obesity is the major risk factor for OSA.
The objectives of this article are to review the interactions between obesity and OSA, including the increased cardiovascular risk, and highlight the importance of using OSA diagnosis as a critical time to address obesity itself and other cardiovascular risk factors.
Snoring and symptoms of OSA frequently worsen during periods of rapid weight gain. Obesity and metabolic factors (eg hypertension, hyperlipidaemia, insulin resistance) are commonly present at the time of OSA diagnosis. Severe OSA is an independent risk factor for cardiovascular disease and stroke. Continuous positive airway pressure (CPAP) treatment is safe and effective, reduces sleepiness, and improves mood and quality of life; however, the cardiovascular benefits of CPAP are uncertain. Weight loss leads to variable improvement in OSA, is most effective in milder OSA, and has a greater benefit on cardiovascular risk than CPAP.
阻塞性睡眠呼吸暂停(OSA)和肥胖是影响澳大利亚人群的两种常见病症;肥胖是OSA的主要危险因素。
本文的目的是综述肥胖与OSA之间的相互作用,包括心血管风险增加,并强调将OSA诊断作为解决肥胖本身及其他心血管危险因素的关键时机的重要性。
在体重快速增加期间,打鼾和OSA症状常常会加重。在OSA诊断时,肥胖和代谢因素(如高血压、高脂血症、胰岛素抵抗)通常存在。重度OSA是心血管疾病和中风的独立危险因素。持续气道正压通气(CPAP)治疗安全有效,可减轻嗜睡,并改善情绪和生活质量;然而,CPAP对心血管的益处尚不确定。体重减轻会使OSA得到不同程度的改善,在较轻的OSA中最为有效,并且对心血管风险的益处大于CPAP。