Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Utah, 26 N 1900 E, Wintrobe 701, Salt Lake City, UT 84132, USA.
Int J Environ Res Public Health. 2022 Apr 30;19(9):5473. doi: 10.3390/ijerph19095473.
Obstructive sleep apnea (OSA) is a highly prevalent disorder that has profound implications on the outcomes of patients with chronic lung disease. The hallmark of OSA is a collapse of the oropharynx resulting in a transient reduction in airflow, large intrathoracic pressure swings, and intermittent hypoxia and hypercapnia. The subsequent cytokine-mediated inflammatory cascade, coupled with tractional lung injury, damages the lungs and may worsen several conditions, including chronic obstructive pulmonary disease, asthma, interstitial lung disease, and pulmonary hypertension. Further complicating this is the sleep fragmentation and deterioration of sleep quality that occurs because of OSA, which can compound the fatigue and physical exhaustion often experienced by patients due to their chronic lung disease. For patients with many pulmonary disorders, the available evidence suggests that the prompt recognition and treatment of sleep-disordered breathing improves their quality of life and may also alter the course of their illness. However, more robust studies are needed to truly understand this relationship and the impacts of confounding comorbidities such as obesity and gastroesophageal reflux disease. Clinicians taking care of patients with chronic pulmonary disease should screen and treat patients for OSA, given the complex bidirectional relationship OSA has with chronic lung disease.
阻塞性睡眠呼吸暂停（OSA）是一种高发疾病，对慢性肺部疾病患者的预后有深远影响。OSA 的特征是口咽部塌陷，导致气流短暂减少、胸腔内压力大幅波动以及间歇性缺氧和高碳酸血症。随后的细胞因子介导的炎症级联反应，加上牵引性肺损伤，会损害肺部，并可能使多种疾病恶化，包括慢性阻塞性肺疾病、哮喘、间质性肺疾病和肺动脉高压。由于 OSA 还会导致睡眠碎片化和睡眠质量恶化，这使患者因慢性肺部疾病而经常经历的疲劳和身体疲惫更加复杂。对于许多肺部疾病患者，现有证据表明，及时识别和治疗睡眠呼吸障碍可以提高他们的生活质量，也可能改变疾病进程。然而，需要更有力的研究来真正了解这种关系以及肥胖和胃食管反流病等混杂合并症的影响。照顾慢性肺部疾病患者的临床医生应该筛查和治疗 OSA 患者，因为 OSA 与慢性肺部疾病之间存在复杂的双向关系。
