Fluid shift in obstructive sleep apnea: does it really have no role in the pathogenesis?
Fluid shift in obstructive sleep apnea: does it really have no role in the pathogenesis?
复制标题
阻塞性睡眠呼吸暂停中的液体转移：它真的在发病机制中没有任何作用吗？
DOI：
10.1378/chest.11-2650
复制
发表时间：
2012
期刊：
影响因子：
9.6
通讯作者：
A. Mirrakhimov
中科院分区：
文献类型：
--
作者：
A. Mirrakhimov
The study by Jafari and Mohsenin 1 published in a recent issue of CHEST (October 2011) tested the effect of nighttime rostral fl uid shift on the development of obstructive sleep apnea (OSA) and its severity. The strengths of their study were stringent methodology and statistical processing of the received data. In contrast to some prior works, they did not fi nd any effect of fl uid shift on sleep disordered breathing severity. The studied population was likely free of clinically signifi cant excessive fl uid, evidenced by the absence of limb edema. Only three individuals received a diagnosis of heart failure (HF), which was mild and likely clinically compensated. However, most patients with OSA were obese and had thicker necks, which is known to be an OSA risk factor. The authors concluded that fl uid shift unlikely has any role in the pathogenesis of OSA. Some issues are noteworthy. First, it is well known that OSA is a risk factor for arterial hypertension (AH), kidney disease, and HF. That, in turn, may result in fl uid retention. Second, several studies have shown a detrimental effect of fl uid shift on OSA severity in comorbid conditions like HF, 2 AH, 3 and kidney disease. 4 Recently a research group from France confi rmed that f luid shift does, in fact, play a role in that setting. They enrolled subjects with chronic venous insuffi ciency and managed them with daytime compression stockings, which resulted in improved OSA severity. 5
