Interactions Between Obesity and Obstructive Sleep Apnea Implications for Treatment
Interactions Between Obesity and Obstructive Sleep Apnea Implications for Treatment
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DOI：
10.1378/chest.09-0360
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发表时间：
2010-03-01
期刊：
影响因子：
9.6
通讯作者：
Somers, Virend K.
中科院分区：
文献类型：
--
作者：
Romero-Corral, Abel;Caples, Sean M.;Somers, Virend K.
阻塞性睡眠呼吸暂停（OSA）对多个器官和系统产生不利影响，特别是与心血管疾病相关。与OSA相关的几种疾病，如高血压、胰岛素抵抗、全身炎症、内脏脂肪沉积和血脂异常，也存在于与OSA密切相关的其他疾病中，如肥胖和睡眠时间减少。体重减轻不仅与肥胖有关，而且与阻塞性睡眠呼吸暂停有关的特征也有所改善，这表明体重减轻可能是治疗这两种疾病的基石。本综述旨在探讨体重与OSA之间相互作用的最新进展。减肥有助于降低呼吸暂停的严重程度，减轻两种疾病常见的心脏代谢异常。然而，使用保守的策略很难达到和维持减肥效果。由于减肥手术已经成为严重或复杂肥胖的一种替代治疗方法，在睡眠呼吸暂停严重程度和心脏代谢紊乱方面经常看到令人印象深刻的结果。然而，阻塞性睡眠呼吸暂停是一种复杂的疾病，治疗不能局限于任何单一的症状或疾病的特征。相反，需要多学科和综合的策略来实现有效和持久的治疗成功。胸部2010;137 (3): 711 - 719
Obstructive sleep apnea (OSA) adversely affects multiple organs and systems, with particular relevance to cardiovascular disease. Several conditions associated with OSA, such as high BP, insulin resistance, systemic inflammation, visceral fat deposition, and dyslipidemia, are also present in other conditions closely related to OSA, such as obesity and reduced sleep duration. Weight loss has been accompanied by improvement in characteristics related not only to obesity but to OSA as well, suggesting that weight loss might be a cornerstone of the treatment of both conditions. This review seeks to explore recent developments in understanding the interactions between body weight and OSA. Weight loss helps reduce OSA severity and attenuates the cardiometabolic abnormalities common to both diseases. Nevertheless, weight loss has been hard to achieve and maintain using conservative strategies. Since bariatric surgery has emerged as an alternative treatment of severe or complicated obesity, impressive results have often been seen with respect to sleep apnea severity, and cardiometabolic disturbances. However, OSA is a complex condition, and treatment cannot be limited to any single symptom or feature of the disease. Rather, a multidisciplinary and integrated strategy is required to achieve effective and long-lasting therapeutic success. CHEST 2010; 137(3):711-719