Zuhal Arıtürk ATILGAN, Abdurrahman ABAKAY, Sıddık ÜLGEN

Tıkayıcı uyku apne sendromu ve kardiyovasküler sorunlar

Obstrüktif uyku apne sendromu (OSAS), uyku sırasında üst solunum yolunda tekrarlayan tıkanma epizodları ve gündüz aşırı uyku hali ile karakterize bir sendrom olarak tanımlanmaktadır. Son yıllarda, OSAS ile kardiyovasküler hastalıklar arasındaki ilişkilerin ortaya çıkarılması ile önemi giderek artmıştır. OSAS kardiyovasküler hastalıkların patogenezi ile ilişkilidir. Önceki çalışmalarda uyku apnenin hipertansiyon, iskemik kalp hastalığı, inme, pulmoner hipertansiyon, kardiyak aritmi ile ilişkili olduğu, kardiyovasküler mortalite ve morbidite için de bağımsız bir risk faktörü olduğu bildirilmiştir.

Obstructive sleep apnea syndrome and cardiovascular problems

Obstructive sleep apnea syndrome (OSAS) is defined as repeated episodes of upper airway occlusion during sleep with consequent excessive daytime sleepiness. Recently, relationship has been found between cardiovascular disease and OSAS. Therefore OSAS has become more popular today. OSAS is associated with the pathogenesis of cardiovascular disease. A large number of studies have demonstrated that OSAS is an independent risk factor of cardiovascular morbidity and mortality. Sleep apnea was shown to be associated with hypertension, ischemic heart disease, stroke, pulmonary hypertension, cardiac arrhythmia, and cardiovascular mortality.

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1. Partinen M, Jamieson A, Guilleminault C. Long- term outcome for obstruktive sleep apnea syndrome patients: mortality. Chest 1988; 94(12): 1200-4.
2. Köktürk O. Obstrüktif uyku apne sendromu sonuçları. Tüberküloz ve Toraks Dergisi 2000; 48(3): 273-89.
3. Köktürk O. Uykuda solunum bozuklukları. Tarihçe, tanımlar, hastalık spektrumu ve boyutu. Tüberküloz ve Toraks Dergisi 1998; 46(2): 187-92.
4. Strauss RS, Browner WS. Risk for obstructive sleep apnea. Ann Intern Med 2000; 132(8):758-9.
5. Hedner J, Grote L. Cardiovascular consequences of obstructive sleep apnea. Eur Respir Mon 1998; 10(3): 227-65.
6. Phillips B. Sleep-disordered breathing and cardiovascular disease. Sleep Med Rev 2005; 9(2): 131-40.
7. Paris JM, Somers VK. Obstructive sleep apnea and cardiovascular disease. Mayo Clin Proc 2004; 79(11): 1036-46.
8. Roux F, Ambrosio CD, Mohsenin V. Sleep-related breathing disorders and cardiovascular disease. Am J Med 2000; 108(4): 396-402.
9. Loredo JS, Ancoli-Israel S, Dimsdale JE. Sleep quality and blood pressure dipping in obstructive sleep apnea. Am J Hypertens, 2001;14(9):887-92.
10. Alchanatis M, Paradellis G, Pini H, et al. Left ventricular function in patients with obstructive sleep apnea syndrome before and after treatment with nazal continuous positive airway pressure. Respiration 2000;67(4):367-71.
11. Silverberg DS, Oksenberg A. Essential hypertension and abnormal upper airway resistance during sleep. Sleep 1997; 20(8): 794-806.
12. Gula LJ, Krahn AD, Skanes C, et al. Clinical Relevance of Arrhythmias During Sleep: Guidance for Clinicans. Heart 2004; 90(4): 347-52.
13. Sobotka PA, Mayer JH, Bauernfeid RA et. al. Arrhythmias documented by 24-hour continuous ambulatory electrocardigraphhic monitoring in young women without apperent heart disease. Am Heart J 1981; 101(8): 753-9.
14. Guilleminault C, Connoly SJ, Winkle RA, et al. Cardiac arrhythmia and conduction disturbances during sleep in 400 patiennts with sleep apnea syndrome. Am J Cardiol 1983; 52(3): 490-4.
15. Yokoe T, Minoguchi K, Matsuo H. Elevated Levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure. Circulation 2003;107(12):1129-33.
16. Kiely J, McNIcholas W. Cardiovasculer risk factors in with obstructive sleep apnea syndrome. Eur Respir J 2000;16(1):128-33.
17. Punjabi N, Sorkin J, Katzel L et. al. Sleep-disordered breathing and insulin resistance in middle aged and overweight men. Am J Respir Crit Care Med 2002;165(5):677-82.
18. Mooe T, Rabben T, Wiklund U, Sleep disordered breathing in man with coronary artery disease. Chest 1996; 109(6): 659-63.
19. Schmidt-Nowara WW, Coultas DB, et. al. Snoring in a Hispanic-American population: risk factors and association with hypertension and other morbidity. Arch Intern Med 1990;150(5):597-601.
20. Schafer H, Koahler U, Ploch T, et al. Sleep-related myocardial ischemia and sleep structure in patients with obstrüctive sleep apnea and coronary heart disease. Chest 1997; 11 (2): 387-93.
21. Coughlin SR, Mawdsley L, Mugarza JA Obstructive sleep apnea is indepently associated with an increased prevalence of metabolik syndrome Eur Heart J 2004;25(9):735-41.
22. Noda A, Okada T, Yasuma F, et al. Cardiac hypertropy in obstrüktive sleep apnea syndrome. Chest 1995; 107(10): 1538-44.