Division of Sleep Medicine, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, 125 South 31st Street, Translational Resesarch Laboratories, Suite 2100, Philadelphia, PA 19104, USA.
Sleep Med Clin. 2023 Sep;18(3):293-299. doi: 10.1016/j.jsmc.2023.05.003. Epub 2023 Jun 14.
Sleep apnea is heterogeneous in multiple dimensions. There are different physiological risk factors that may have clinical relevance. However, assessing them is challenging. An approach to ascertain them using a simple model of ventilatory control has been proposed. It is based, however, on untenable assumptions. There are limited validation data and reproducibility is not stellar. There are also different symptom subtypes. They have been found in multiple population-based and clinical cohorts worldwide. Symptomatic benefit from therapy is most marked in the excessively sleepy subtype. This group may also be the group at increased CV risk from obstructive sleep apnea.
睡眠呼吸暂停在多个维度上存在异质性。有不同的生理风险因素可能具有临床相关性。然而，评估这些因素具有挑战性。已经提出了一种使用通气控制的简单模型来确定这些因素的方法。然而，它基于站不住脚的假设。验证数据有限，重现性也不是很好。也有不同的症状亚型。它们已经在世界各地的多个基于人群和临床队列中被发现。治疗对过度嗜睡亚型的症状获益最为显著。这个群体也可能是阻塞性睡眠呼吸暂停心血管风险增加的群体。
