Bonsignore Maria R, Baiamonte Pierpaolo, Mazzuca Emilia, Castrogiovanni Alessandra, Marrone Oreste
1Division of Respiratory Medicine, Biomedical Department of Internal Medicine and Medical Specialties (Di.Bi.M.I.S), University Hospital Paolo Giaccone, University of Palermo, Piazza delle Cliniche, 2, 90100 Palermo, Italy.
2National Research Council (CNR), Institute of Biomedicine and Molecular Immunology (IBIM), Palermo, Italy.
Multidiscip Respir Med. 2019 Feb 14;14:8. doi: 10.1186/s40248-019-0172-9. eCollection 2019.
Obstructive sleep apnea (OSA) is a highly prevalent disease, and is traditionally associated with increased cardiovascular risk. The role of comorbidities in OSA patients has emerged recently, and new conditions significantly associated with OSA are increasingly reported. A high comorbidity burden worsens prognosis, but some data suggest that CPAP might be protective especially in patients with comorbidities. Aim of this narrative review is to provide an update on recent studies, with special attention to cardiovascular and cerebrovascular comorbidities, the metabolic syndrome and type 2 diabetes, asthma, COPD and cancer. Better phenotypic characterization of OSA patients, including comorbidities, will help to provide better individualized care. The unsatisfactory adherence to CPAP in patients without daytime sleepiness should prompt clinicians to examine the overall risk profile of each patient in order to identify subjects at high risk for worse prognosis and provide the optimal treatment not only for OSA, but also for comorbidities.
阻塞性睡眠呼吸暂停（OSA）是一种高度流行的疾病，传统上与心血管风险增加有关。合并症在OSA患者中的作用最近已显现出来，并且越来越多的新疾病被报道与OSA显著相关。高合并症负担会使预后恶化，但一些数据表明持续气道正压通气（CPAP）可能具有保护作用，尤其是在合并症患者中。本叙述性综述的目的是提供近期研究的最新情况，特别关注心血管和脑血管合并症、代谢综合征和2型糖尿病、哮喘、慢性阻塞性肺疾病（COPD）和癌症。对OSA患者进行更好的表型特征描述，包括合并症，将有助于提供更好的个体化护理。无日间嗜睡的患者对CPAP的依从性不理想，这应促使临床医生检查每位患者的总体风险状况，以便识别预后较差的高危患者，并不仅为OSA，也为合并症提供最佳治疗。
