O'Driscoll Denise M, Young Alan C
Department of Respiratory and Sleep Medicine, Eastern Health, Box Hill, Victoria, Australia.
Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia.
Respirology. 2023 Jun;28(6):518-524. doi: 10.1111/resp.14500. Epub 2023 Mar 29.
COVID-19 AND SLEEP: The COVID-19 pandemic is associated with an increase in insomnia and impaired sleep quality Health care workers are particularly susceptible and improved with cognitive behavioural therapy for insomnia (CBT-I) Long COVID has significant effects on sleep OSA impacts on the severity of acute COVID-19 illness OBSTRUCTIVE SLEEP APNOEA: Large trials of clinically representative patients confirm the cardiovascular benefits of CPAP treatment in OSA CPAP may improve long-term cognitive outcomes in OSA, but further research is needed Racial disparities in OSA prevalence and mortality risk are becoming evident Periodic evaluation of OSA risk in pregnancy is important as timing may be key for intervention to prevent or treat cardiovascular risk factors INSOMNIA: Comorbid insomnia and obstructive sleep apnoea (COMISA) can frequently co-exist and the combined negative effects of both may be deleterious, particularly to cardiovascular health There is evidence for effectiveness with novel orexin receptor antagonists.
新冠疫情与失眠增加及睡眠质量受损有关。医护人员尤其易受影响，而失眠的认知行为疗法（CBT-I）可改善睡眠。新冠后症状对睡眠有显著影响。阻塞性睡眠呼吸暂停对急性新冠疾病的严重程度有影响。
对具有临床代表性患者的大型试验证实了持续气道正压通气（CPAP）治疗阻塞性睡眠呼吸暂停对心血管的益处。CPAP可能改善阻塞性睡眠呼吸暂停患者的长期认知结局，但仍需进一步研究。阻塞性睡眠呼吸暂停患病率和死亡风险的种族差异正变得明显。孕期定期评估阻塞性睡眠呼吸暂停风险很重要，因为干预时机可能是预防或治疗心血管危险因素的关键。
失眠与阻塞性睡眠呼吸暂停合并症（COMISA）经常共存，两者的综合负面影响可能有害，尤其是对心血管健康。有证据表明新型食欲素受体拮抗剂有效。
