Castiglione Vincenzo, Morfino Paolo, Gentile Francesco, Airò Edoardo, Passino Claudio, Giannoni Alberto, Emdin Michele
Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa.
Fondazione Toscana Gabriele Monasterio, Pisa.
G Ital Cardiol (Rome). 2023 Dec;24(12):979-989. doi: 10.1714/4139.41345.
Obstructive sleep apneas (OSA) are a breathing disorder characterized by recurrent apneas and hypopneas associated with complete or partial obstruction of the upper airways during sleep, resulting in disturbed sleep architecture, repeated hypoxemia and awakenings, and daytime sleepiness. OSA syndrome affects up to 34% of men and 17% of women in Western countries. Abnormalities in upper airway anatomy (frequently due to obesity), muscle tone, or neural control of breathing are the main causes. OSA is associated with impaired cognitive function and favors the onset of hypertension, being a major determinant of resistant hypertension, and may favor cardiovascular diseases (e.g., coronary artery disease and heart failure), thereby increasing mortality. Polysomnography and (cardio)-respiratory portable systems are used to diagnose and determine the severity of OSA. Management of OSA includes lifestyle modifications, such as weight loss and avoidance of supine sleep position, and continuous positive airway pressure. Mandibular advancement devices and upper airway surgery may also be appropriate for some patients. Hypoglossal nerve stimulation and pharmacological interventions are currently investigated to improve symptoms and outcomes.
阻塞性睡眠呼吸暂停（OSA）是一种呼吸障碍，其特征为睡眠期间反复出现呼吸暂停和呼吸浅慢，伴有上气道完全或部分阻塞，导致睡眠结构紊乱、反复低氧血症和觉醒，以及日间嗜睡。在西方国家，OSA综合征影响多达34%的男性和17%的女性。上气道解剖结构异常（常因肥胖所致）、肌张力或呼吸的神经控制异常是主要病因。OSA与认知功能受损相关，易引发高血压，是难治性高血压的主要决定因素，还可能促使心血管疾病（如冠状动脉疾病和心力衰竭）的发生，从而增加死亡率。多导睡眠图和（心脏）呼吸便携式系统用于诊断和确定OSA的严重程度。OSA的治疗包括生活方式改变，如减肥和避免仰卧睡眠姿势，以及持续气道正压通气。下颌前移装置和上气道手术对某些患者可能也适用。目前正在研究舌下神经刺激和药物干预措施以改善症状和治疗效果。
