医学
阻塞性睡眠呼吸暂停
心力衰竭
低氧血症
白天过度嗜睡
气道正压
心脏病学
心房颤动
持续气道正压
睡眠呼吸障碍
睡眠呼吸暂停
内科学
随机对照试验
口腔矫治器
呼吸
睡眠(系统调用)
疾病
重症监护医学
麻醉
睡眠障碍
失眠症
精神科
作者
Martin R. Cowie,Dominik Linz,Susan Redline,Virend K. Somers,Anita K. Simonds
标识
DOI:10.1016/j.jacc.2021.05.048
摘要
Sleep disordered breathing causes repetitive episodes of nocturnal hypoxemia, sympathetic nervous activation, and cortical arousal, often associated with excessive daytime sleepiness. Sleep disordered breathing is common in people with, or at risk of, cardiovascular (CV) disease including those who are obese or have hypertension, coronary disease, heart failure, or atrial fibrillation. Current therapy of obstructive sleep apnea includes weight loss (if obese), exercise, and positive airway pressure (PAP) therapy. This improves daytime sleepiness. Obstructive sleep apnea is associated with increased CV risk, but treatment with PAP in randomized trials has not been shown to improve CV outcome. Central sleep apnea (CSA) is not usually associated with daytime sleepiness in heart failure or atrial fibrillation and is a marker of increased CV risk, but PAP has been shown to be harmful in 1 randomized trial. The benefits of better phenotyping, targeting of higher-risk patients, and a more personalized approach to therapy are being explored in ongoing trials.
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