Güleser SAYLAM, Ceren ÜNLÜ ERSÖZ, Emel TATAR ÇADALLI

Obstrüktif uyku apne sendromu ve sistemik hastalıkların birlikteliği: Neden mi? Yoksa sonuç mu?

Obstrüktif uyku apne sendromu (OUAS); uyku sırasında tekrarlayan tam (apne) veya parsiyel (hipopne) üst solunum yolu obstrüksiyonu epizodları ve sıklıkla kan oksijen satürasyonunda azalma ile karakterize bir sendromdur. OUAS için en önemli risk faktörleri olan yaş, cinsiyet ve obezitenin aynı zamanda bir çok sistemik hastalığın oluşumunda önemli rol oynadığı bilinmektedir. OUAS ve sistemik hastalıkların sadece ortak risk faktörlerini paylaşmadıklarını, birbirlerinden diğer risk faktörleri olmaksızın etkilendiklerini gösteren çalışmalar bulunmaktadır. OUAS’da meydana gelen hipoksemi, sempatik aktivitede artış, intratorasik negatif basınçta artış gibi patofizyolojik değişiklikler bazı sistemik hastalıkların gelişiminde rol oynamaktadır. Benzer şekilde sistemik hastalıklarla meydana gelen hemodinamik değişiklikler de OUAS gelişiminden sorumlu olabilmektedir. Bu hastalıkların birbiriyle olan bağlantıları sadece neden ve sonuç ilişkisi olmalarından kaynaklanmamaktadır. Aynı hastada OUAS ve diğer sistemik hastalıklardan birinin birlikte bulunması hastanın morbidite ve mortalitesini önemli ölçüde etkilemektedir. Bu nedenlerle OUAS ve sistemik başka bir hastalığa sahip hastalarda tedavi her iki hastalığı da kapsayacak şekilde düzenlenmelidir. Bu yazıda kardiovasküler, serebrovasküler, pulmoner ve endokrin sisteme ait bazı hastalıkların OUAS ile olan ilişkilerini gözden geçirdik.

Associated systemic disease in obstructive sleep apnea syndrome: Is it cause or result?

Obstructive sleep apnea syndrome (OSAS) is characterized by repetitive episodes of complete (apnea) or partial (hipopnea) obstruction of upper airways and frequently decrease in blood oxygene saturations during sleep. The most important risk factors for OSAS are age, gender and obesity and they also take important role in the development of many systemic diseases. OSAS and systemic diseases do not only share common risk factors, but there are also reports that they affect each other without the presence of other risk factors. Pathophysiological changes of OSAS like hypoxemia, increased sympathetic activation, increased negative intrathoracic pressure take part in the developement of some systemic diseases. Similarly, hemodynamic changes occured in systemic diseases may be responsable for developement of OSAS. These diseases are not only reason and result for each other. The presence of both OSAS and one of the other systemic diseases in the same patient affects the morbidity and mortality significantly. Because of these reasons, treatment must be given for both diseases in patients with OSAS and another systemic disease. In this article, we reviewed the relationship between some of the cardiovascular, serebrovascular, pulmonary and endocrine diseases and OSAS.

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