Mutual Influence of Obstructive Sleep Apnea and Metabolic Syndrome
The aim of this study was to find any cause-and-effect relationships between the development of obstructive sleep apnoea and the occurrence of metabolic changes affecting the progression of the disease. Russian and foreign articles on obstructive sleep apnoea and the complications of this disease were analysed. Special attention was paid to data on metabolic changes. Any cause-and-effect relationships for the progression of obstructive sleep apnoea and metabolic syndrome were established and subjected to logical analysis, which made it possible to conclude that these diseases are interrelated. Intermittent hypoxia and sleep fragmentation arising from obstructive sleep apnoea and metabolic syndrome lead to a decrease in insulin sensitivity, an increase in the activity of the sympathetic nervous system and systemic inflammation, all of which are important factors in the progression of the metabolic syndrome. In turn, metabolic syndrome is an independent risk factor for obstructive sleep apnoea, for example, un-correctable glycemia, desensitises carotid bodies and pharyngeal muscles, contributing to the occurrence of respiratory disorders in a dream, which suggests the emergence of a “vicious circle” in the pathogenesis of both diseases. Thus, we can talk about the bilateral effects of obstructive sleep apnoea and metabolic syndrome. A special therapy (a method of treatment by creating a constant positive pressure in the airways during a night’s sleep) for obstructive sleep apnoea has a positive effect on the degree of insulin resistance and the level of adipokines. This circumstance necessitates the timely initiation of therapy in patients with metabolic syndrome who have breathing disorders during sleep. The consulting physician, who is confronted with the problem of respiratory disorders during night sleep, needs to understand the true nature of the disease in a particular situation to form correct and precise recommendations to the patient; timely diagnose the complications of obstructive sleep apnoea syndrome and hence refer patients to the appropriate specialists. Complications of obstructive sleep apnoea are no less dangerous than the main clinical manifestations, which necessitates an integrated approach to a patient with obstructive sleep apnoea and metabolic syndrome. The interrelationship between obstructive sleep apnoea and metabolic syndrome as described by us will allow the practitioners to more clearly orient themselves in the variety of clinical manifestations of obstructive sleep apnoea and the selection of an effective treatment.
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