THE VASCULAR CONSEQUENCES OF SNORING AND OBSTRUCTIVE SLEEP APNOEA

打鼾指的是睡眠时喉咙明显变窄，并使围绕这部分气道的软组织振动，从而产生典型的打鼾噪音。在成年人中，习惯性打鼾是一个非常普遍的问题，患病率在20-40%之间。更严重的打鼾形式与阻塞性睡眠呼吸暂停综合症有关，这是一种睡眠时喉咙完全阻塞在舌头和上颚后面，导致短时间呼吸停止的情况。睡眠呼吸暂停是成年男性最常见的慢性疾病之一，45岁以上的男性中有5%患有睡眠呼吸暂停。现在越来越多的人认识到，没有睡眠呼吸暂停的打鼾可能是这两种非常常见和严重的医学疾病发展的独立风险因素。然而，还没有研究探索打鼾可能导致中风和高血压的机制。在本提案中，我们将探讨慢性打鼾通过颈部组织向颈动脉传递压力波的假设，颈动脉是大脑的主要血液供应。我们认为，这条动脉的慢性振动会导致动脉粥样硬化和高血压等疾病。我们的研究将有助于证明这是打鼾和睡眠呼吸暂停可能导致重要血管疾病发展的共同机制。研究还将确定打鼾者（伴和不伴阻塞性睡眠呼吸暂停）颈动脉粥样硬化的患病率，以及有完全性卒中风险的患者的习惯性打鼾和阻塞性睡眠呼吸暂停的患病率。认识到打鼾是血管疾病的一个独立危险因素，显然对未来管理打鼾在预防中风和高血压方面具有重要和广泛的意义。

Snoring refers to a condition where the throat narrows significantly during sleep, and allows the soft tissues which surround this part of the airway to vibrate and create the typical snoring noise. Habitual snoring is a very common problem in the adult population, with a prevalence of between 20-40%. More severe forms of snoring are associated with the obstructive sleep apnoea syndrome, which is a condition in which the throat completely blocks behind the tongue and palate during sleep leading to cessation of breathing for short periods of time. Sleep apnoea is among the commonest chronic disorders of adult males occurring in 5% of men over the age of 45 years. Increasingly, it is now recognised that snoring, without sleep apnoea, may be an independent risk factor for the development of both of these very common and significant medical disorders. However, there have been no studies exploring the mechanisms by which snoring might contribute to the development of stroke and hypertension. In this proposal, we will explore the hypothesis that chronic snoring transmits a pressure wave through the tissues of the neck to the carotid artery which is the main blood supply to the brain. We propose that the chronic vibration of this artery leads to disease such as atherosclerosis and hypertension. Our studies will help to prove that this is a common mechanism whereby both snoring and sleep apnoea may contribute to the development of important vascular diseases. Studies will also establish the prevalence of carotid atherosclerosis in snorers (with and without OSA), and the prevalence of habitual snoring and OSA in patients at risk of developoing completed stroke. The recognition of snoring as an independent risk factor for vascular disease will clearly have important and wide ranging implications for the future management of snoring in the prevention of stroke and hypertension.