Alevroudis Ioannis, Petridou Magda, Sakkou Agni, Kotoulas Serafeim-Chrysovalantis, Matzolas Sotirios, Roumelis Panagiotis, Stougianni Maria, Massa Eleni, Mouloudi Eleni
Adult ICU, General Hospital of Thessaloniki "Ippokrateio", 54642 Thessaloniki, Greece.
Third Department of Cardiology, General Hospital of Thessaloniki "Ippokrateio", Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece.
Rev Cardiovasc Med. 2025 May 6;26(5):28244. doi: 10.31083/RCM28244. eCollection 2025 May.
Takotsubo syndrome (TTS), also known as stress-induced cardiomyopathy or "broken heart syndrome", is characterized by transient left ventricular dysfunction, often triggered by emotional or physical stress. Emerging evidence suggests that sleep-disordered breathing (SDB) and sleep disruption may play a significant role in the pathophysiology and exacerbation of TTS. This review explores the influence of conditions such as obstructive sleep apnea (OSA), insomnia, and other sleep disturbances on the onset and progression of TTS. SDB, particularly OSA, is marked by repetitive episodes of upper airway obstruction during sleep, leading to intermittent hypoxia and increased sympathetic nervous system activity. These physiological changes can trigger or exacerbate TTS by promoting myocardial stress and impairing autonomic regulation. Insomnia and other forms of sleep disruption also contribute to heightened sympathetic activity and elevated stress hormone levels, which may precipitate TTS in susceptible individuals. Thus, this review synthesizes current research on the mechanisms linking sleep disturbances to TTS, highlighting the impact of nocturnal hypoxia, sleep fragmentation, and autonomic dysregulation. Moreover, this review discusses the clinical implications of these findings, emphasizing the need to screen and manage sleep disorders in patients with or at risk of TTS. Addressing sleep disturbances through therapeutic interventions may reduce the incidence and recurrence of TTS, offering a novel approach to managing this condition. In conclusion, this review underscores the importance of recognizing and treating SDB and sleep disruption as potential contributors to Takotsubo syndrome. Future research should focus on elucidating the precise mechanisms involved and determining effective strategies for integrating sleep management into the care of patients with TTS.
应激性心肌病（TTS），也称为应激性心肌病或“心碎综合征”，其特征为短暂性左心室功能障碍，常由情绪或身体应激引发。新出现的证据表明，睡眠呼吸紊乱（SDB）和睡眠中断可能在TTS的病理生理学和病情加重过程中起重要作用。本综述探讨阻塞性睡眠呼吸暂停（OSA）、失眠及其他睡眠障碍等情况对TTS发病和进展的影响。SDB，尤其是OSA，其特征为睡眠期间上呼吸道反复阻塞发作，导致间歇性缺氧和交感神经系统活动增加。这些生理变化可通过加重心肌应激和损害自主神经调节来触发或加重TTS。失眠和其他形式的睡眠中断也会导致交感神经活动增强和应激激素水平升高，这可能使易感个体发生TTS。因此，本综述综合了目前关于睡眠障碍与TTS之间联系机制的研究，强调了夜间缺氧、睡眠片段化和自主神经失调的影响。此外，本综述讨论了这些发现的临床意义，强调对TTS患者或有TTS风险的患者进行睡眠障碍筛查和管理的必要性。通过治疗干预解决睡眠障碍可能会降低TTS的发病率和复发率，为管理这种疾病提供一种新方法。总之，本综述强调了认识和治疗SDB及睡眠中断作为应激性心肌病潜在促成因素的重要性。未来的研究应侧重于阐明其中的确切机制，并确定将睡眠管理纳入TTS患者护理的有效策略。
