Pauzele repetitive de respira\u0163ie din timpul somnului modific\u0103 interac\u0163iunile fiziologice dintre somn \u015fi sistemul cardiovascular. Astfel, fragmentarea somnului ca \u015fi alte anomalii existente la pacien\u0163ii cu SASO, cum ar fi cre\u015fterea activit\u0103\u0163ii simpatice, disfunc\u0163ia vascular\u0103 endotelial\u0103, cre\u015fterea stresului oxidativ, inflama\u0163ia, cre\u015fterea agregabilit\u0103\u0163ii plachetare \u015fi modific\u0103rile metabolice, pot fi implicate \u00een ini\u0163ierea \u015fi progresia bolilor cardiovasculare.<\/p>\n
SASO poate conduce la Hipertensiune arterial\u0103 esen\u0163ial\u0103, boal\u0103 coronarian\u0103 ischemic\u0103a, infarct de miocard, insuficien\u0163\u0103 cardiac\u0103, aritmii cardiace, Hipertensiune pulmonar\u0103, accidente vasculare cerebrale \u015fi moarte subit\u0103 \u00een somn.<\/p>\n
Odat\u0103 cu apari\u0163ia epidemiei de obezitate exist\u0103 \u015fi o cre\u015ftere a con\u015ftientiz\u0103rii tulbur\u0103rilor de somn ca factor de risc al bolilor cardiovasculare. SASO se asociaz\u0103 \u00een mod obi\u015fnuit cu obezitatea \u015fi se \u00eent\u00e2lne\u015fte frecvent la pacien\u0163i cu hipertensiune, insuficien\u0163\u0103 cardiac\u0103, aritmii \u015fi accidente vasculare cerebrale.<\/p>\n
Consecin\u0163ele hemodinamice acute ale SASO sunt vasoconstric\u0163ia mediate simpatic, cre\u015fterea presiunii sistemice \u015fi pulmonare, cre\u015fterea post sarcinii ventriculului st\u00e2ng \u015fi modific\u0103ri ale debitului cardiac legate de respira\u0163ie.<\/p>\n
SASO se poate asocia cu modific\u0103ri metabolice care pot predispune la cre\u015fterea \u00een greutate \u015fi risc cardiovascular. Leptina este un hormone derivat din adipocite care scade apetitul \u015fi induce sa\u0163ietatea. Nivelul de leptin\u0103 este crescut la obezi ceea ce sugereaz\u0103 rezisten\u0163\u0103 la efectele metabolice ale leptinei. Leptina predispune la agregare plachetar\u0103 \u015fi a fost implicat\u0103 ca marker independent \u00een cre\u015fterea riscului cardiovascular. Tratamentul cu CPAP reduce nivelul de leptin\u0103 \u015fi poate fi asociat cu sc\u0103derea acumul\u0103rii de gr\u0103sime visceral\u0103.<\/p>\n
SASO poate modifica toleran\u0163a la glucoz\u0103. Pacientii cu SASO pot avea glicemia \u015fi hemoglobina glicozilat\u0103 crescut\u0103, independent de greutatea corporal\u0103. SASO sever se \u00eenso\u0163e\u015fte de cre\u015fterea de 5 ori a riscului de diabet zaharat. Alterarea toleran\u0163ei la glucoz\u0103 la pacien\u0163ii cu SASO, independent de efectele obezit\u0103\u0163ii poate avea leg\u0103tur\u0103 cu deprivarea de somn, activarea simpatic\u0103 \u015fi rezisten\u0163a la leptin\u0103.<\/p>\n
Sindromul de apnee \u00een somn se diagnosticheaz\u0103 cu usurin\u0163\u0103 \u015fi este tratabil. Diagnosticul se realizeaz\u0103 \u00een laboratoare de poligrafie\/polisomnografie cu ajutorul unui aparat pe care pacientul \u00eel poart\u0103 pe timpul nop\u0163ii, aparat care\u00a0 \u00eenregistreaz\u0103 anumi\u0163i parametri.\u00a0 Tratamentul se realizeaz\u0103 cu ajutorul unui alt aparat care se nume\u015fte CPAP \u015fi care introduce aer cu presiune \u00een c\u0103ile respiratorii \u015fi astfel se men\u0163ine g\u00e2tul deschis pe timpul somnului. La pacien\u0163ii nediagnostica\u0163i \u015fi netrata\u0163i pot ap\u0103rea complica\u0163ii ale bolilor cardiace \u015fi vasculare \u015fi lipsa de r\u0103spuns la tratamentul conven\u0163ional al acestor afec\u0163iuni, de unde reiese importan\u0163a diagnosticului precoce al sindromului de apnee \u00een somn \u015fi tratamentul acestei boli.<\/p>\nDr. Grigoriu Liliana Medic specialist pneumolog Metropolitan Hospital <\/em><\/figcaption><\/figure>\n <\/p>\n","protected":false},"excerpt":{"rendered":"
Sindromul de apnee \u00een somn de tip obstructiv (SASO), reprezint\u0103 o afec\u0163iune caracterizat\u0103 \u00een principal prin somnolen\u0163\u0103 diurn\u0103, pauze de respira\u0163ie \u00een timpul somnului \u015fi sfor\u0103it. Pe l\u00e2ng\u0103 aceste simptome […]<\/p>\n","protected":false},"author":4,"featured_media":5970,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[33,564],"tags":[],"class_list":["post-5967","post","type-post","status-publish","format-standard","has-post-thumbnail","category-articole","category-pneumologie"],"yoast_head":"\n
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![\"apnee-semne\"](\"https:\/\/jurmed.ro\/medici\/wp-content\/uploads\/sites\/2\/2016\/09\/Apnee-semne.jpg\")
<\/a>Sindromul de apnee \u00een somn este tot mai mult implicat \u00een ini\u0163ierea \u015fi progresia bolilor cardiovasculare.<\/p>\n