Bezdech senny w praktyce kardiologa Artykuł przeglądowy
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wrz 30, 2008
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bezdech senny, chorobowość sercowo-naczyniowa, terapia CPAP
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Abstrakt
W ostatnich latach obserwujemy wzrastające zainteresowanie badaniami nad snem w chorobach układu krążenia. Mamy coraz więcej dowodów na to, że zaburzenie struktury snu, a zwłaszcza bezdech senny, może odgrywać istotną rolę w etiopatogenezie szeregu chorób układu sercowo-naczyniowego. Głośne, nieregularne chrapanie, pierwotnie traktowane jako „kosmetyczna” przypadłość otyłych panów, przyczynia się do rozwoju nadciśnienia tętniczego, zwiększa ryzyko rozwoju choroby niedokrwiennej serca, jest czynnikiem niekorzystnym rokowniczo w ChNS oraz w sposób niezależny predysponuje do wystąpienia udaru mózgu. Istnieją dowody, że nieleczony bezdech senny bezpośrednio upośledza pracę serca oraz może prowokować arytmie. Obserwacje pacjentów z dysfunkcją skurczową serca sugerują, że zaburzenia oddechu w czasie snu towarzyszą bardziej zaawansowanej postaci niewydolności serca, w której są niezależnym, niekorzystnym czynnikiem prognostycznym. Najważniejsze jednak wydają się doniesienia o poprawie rokowania u pacjentów ze schorzeniami serca i naczyń, uzyskanej dzięki wdrożeniu terapii bezdechów sennych.
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Wolf , J., & Narkiewicz , K. (2008). Bezdech senny w praktyce kardiologa . Kardiologia W Praktyce, 2(3), 110-119. Pobrano z https://www.journalsmededu.pl/index.php/kwp/article/view/1681
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Utwór dostępny jest na licencji Creative Commons Uznanie autorstwa – Użycie niekomercyjne – Bez utworów zależnych 4.0 Międzynarodowe.
Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
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4. Young T., Palta M., Dempsey J., Skarrud J., Weber S., Badr S.: The occurrence of sleep-disordered breathing among middle-aged adults. N. Engl. J. Med. 1993, 328: 1230-1235.
5. Pływaczewski R., Bednarek M., Jonczak L., Zieliński J.: Sleep-disordered breathing in a middle-aged and older Polish urban population. J. Sleep Res. 2008,17: 73-81.
6. Brooks D., Horner R.L., Kozar L.F., Render-Teixeira C.L., Phillipson E.A.: Obstructive sleep apnea as a cause of systemic hypertension. Evidence from a canine model. J. Clin. Invest. 1997, 99: 106-109.
7. Bixler E.O., Vgontzas A.N., Lin H.M., Ten Have T., Leiby B.E., Vela-Bueno A., Kales A.: Association of hypertension and sleep-disordered breathing. Arch. of Intern. Med. 2000, 160: 2289-2295.
8. Young T., Peppard P., Palta M., Hla K.M., Finn L., Morgan B., Skatrud J.: Population-based study of sleep-disordered breathing as a risk factor for hypertension. Arch. Intern. Med. 1997, 157: 1746-1752.
9. Nieto F.J., Young T.B., Bonnie K.L., Shahar E., Samet J.M., Redline S., D’Agostino R.B., Newman A.B., Lebowitz M., Pickering T.C. (for the Sleep Heart Health Study): Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. JAMA 2000, 283: 1829-1836.
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11. Somers V.K., Dyken M.E., Clary M.P., Abboud F.M.: Sympathetic neural mechanisms in obstructive sleep apnea. J. Clin. Invest. 1995, 96: 1897-1904.
12. Dolan E., Stanton A., Thijs L., Hinedi K., Atkins N., Mc- Clory S., Den Hond E., McCormack P., Staessen J.A., O’Brien E.: Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: the Dublin outcome study. Hypertension 2005, 46: 156-161.
13. Fagard R.H., Celis H., Thijs L., Staessen J.A., Clement D.L., De Buyzere M.L., De Bacquer D.A.: Daytime and nighttime blood pressure as predictors of death and cause-specific cardiovascular events in hypertension. Hypertension 2008, 51: 55-61.
14. Sega R., Facchetti R., Bombelli M., Cesana G., Corrao G., Grassi G., Mancia G.: Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population: follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study. Circulation 2005, 111: 1777-1783.
15. Kikuya M., Ohkubo T., Asayama K., Metoki H., Obara T., Saito S., Hashimoto J., Totsune K., Hoshi H., Satoh H., Imai Y.: Ambulatory blood pressure and 10-year risk of cardiovascular and noncardiovascular mortality: the Ohasama study. Hypertension 2005, 45: 240-245.
16. Baguet J.P., Lévy P., Barone-Rochette G., Tamisier R., Pierre H., Peeters M., Mallion J.M., Pépin J.L.: Masked hypertension in obstructive sleep apnea syndrome. J. Hypertens. 2008, 26: 885-892.
17. Peppard P.E., Young T., Palta M., Skatrud J.: Prospective study of the association between sleep-disordered breathing and hypertension. N. Engl. J. Med. 2000, 342: 1378-1784.
18. Haas D.C., Foster G.L., Nieto F.J., Redline S., Resnick H.E., Robbins J.A., Young T., Pickering T.G.: Age-dependent associations between sleep-disordered breathing and hypertension: importance of discriminating between systolic/diastolic hypertension and isolated systolic hypertension in the Sleep Heart Health Study. Circulation 2005, 111: 614-621.
19. Guilleminault C., Khramsov A., Stoohs R.A., Kushida C., Pelayo R., Kreutzer M.L., Chowdhuri S.: Abnormal blood pressure in prepubertal children with sleepdisordered breathing. Pediatr. Res. 2004, 55: 76-84.
20. Leung L.C., Ng D.K., Lau M.W., Chan C.H., Kwok K.L., Chow P.Y., Cheung J.M.: Twenty-four-hour ambulatory BP in snoring children with obstructive sleep apnea syndrome. Chest 2006, 130: 1009-1017.
21. Li A.M., Au C.T., Sung R.Y., Ho C., Ng P.C., Fok T.F., Wing Y.K.: Ambulatory Blood Pressure in Children with Obstructive Sleep Apnoea - A Community Based Study. Thorax 2008 (w druku).
22. Wilcox I., Grunstein R.R., Hedner J.A. et al.: Effect of nasal continuous positive airway pressure during sleep on 24-hour blood pressure in obstructive sleep apnea. Sleep 1993, 16: 539-44.
23. Pepperell J.C., Ramdassingh-Dow S., Crosthwaite N. et al.: Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial. Lancet 2002, 359: 204-210.
24. Becker H.F., Jerrentrup A., Ploch T. et al.: Effect of Nasal Continuous Positive Airway Pressure Treatment on Blood Pressure in Patients With Obstructive Sleep Apnea. Circulation 2003, 107: 68-73.
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