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睡眠紊乱不利于心脏健康:一篇综述

Disturbed Sleep is Not Good for the Heart: A Narrative Review.

机构信息

Department of Internal Medicine, Tianjin Medical University, Tianjin, P.R. China.

Avalon University School of Medicine, Willemstad, Curaçao.

出版信息

Curr Cardiol Rev. 2023;19(3):e301122211378. doi: 10.2174/1573403X19666221130100141.

Abstract

Sleep-related breathing disorders, including obstructive sleep apnea (OSA) and central sleep apnea (CSA), have a major impact on cardiovascular function. It has shown an association with hypertension, coronary artery disease, cardiac arrhythmias, sudden cardiac death, and congestive heart failure (CHF). This review focuses on highlighting the relationship between sleep apnea and CHF. We discuss the underlying pathophysiology, which involves the mechanical, neurohormonal, and inflammatory mechanisms; in addition, the similarities and differentiating clinical features of OSA in patients with CHF and without CHF. We have also discussed several treatment strategies, including weight loss, continuous positive airway pressure (CPAP), supplemental oxygen therapy, theophylline, acetazolamide, mandibular advancement device, and hypoglossal nerve stimulation (HGNS). We conclude that since there are several overlapping clinical features in patients with OSA with Heart Failure (HF) and without HF, early detection and treatment are crucial to decrease the risk of HF, coronary artery disease, and stroke.

摘要

睡眠相关呼吸障碍,包括阻塞性睡眠呼吸暂停(OSA)和中枢性睡眠呼吸暂停(CSA),对心血管功能有重大影响。它与高血压、冠状动脉疾病、心律失常、心源性猝死和充血性心力衰竭(CHF)有关。这篇综述重点强调了睡眠呼吸暂停与 CHF 之间的关系。我们讨论了潜在的病理生理学,包括机械、神经激素和炎症机制;此外,还讨论了 CHF 患者和非 CHF 患者 OSA 的相似和不同的临床特征。我们还讨论了几种治疗策略,包括减肥、持续气道正压通气(CPAP)、补充氧气疗法、茶碱、乙酰唑胺、下颌前伸装置和舌下神经刺激(HGNS)。我们的结论是,由于 OSA 合并心力衰竭(HF)和不合并 HF 的患者存在几种重叠的临床特征,因此早期检测和治疗对于降低 HF、冠状动脉疾病和中风的风险至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bef8/10280991/8053f4dcfa99/CCR-19-E301122211378_F1.jpg

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