快速眼动相关阻塞性睡眠呼吸暂停低通气综合征的研究进展

Research advances in rapid eye movement related obstructive sleep apnea-hypopnea syndrome

快速眼动相关阻塞性睡眠呼吸暂停低通气综合征(REM-OSAHS)是指仅发生或主要发生在快速眼动(REM)睡眠期的呼吸暂停和低通气。尽管REM-OSAHS在临床和社区人群中普遍存在,但其发生的病理生理机制和可能引发的临床后果尚未明确,干预策略也仍在探索中。研究发现,REM-OSAHS与高血压、血糖调节受损、代谢综合征及心脑血管事件等独立相关。REM期存在心血管系统不稳定、交感神经兴奋性增加、呼吸反射减弱等生理特征,可能使得REM-OSAHS比非快速眼动相关阻塞性睡眠呼吸暂停低通气综合征具有更大的健康风险和更重要的临床意义,因此,REM-OSAHS在临床中亟需被广泛认识和研究。本文围绕近年来REM-OSAHS的临床意义、治疗策略等做一综述,进一步思考REM-OSAHS的诊治问题,旨在加深临床医师对REM-OSAHS的认识,便于早期诊疗,以期为相关研究提供参考。

Rapid eye movement related obstructive sleep apnea-hypopnea syndrome(REM-OSAHS)refers to apnea and hypopnea that occur only or predominantly during REM sleep.Although REM-OSAHS is very common in both clinical and community populations,its specific pathophysiological mechanisms and long-term possible clinical consequences are not fully understood,and its intervention strategies are still being explored.Studies have found that REM-OSAHS is independently associated with hypertension,impaired blood glucose regulation,metabolic syndrome and cardio-cerebrovascular events.Physiological features such as instability of the cardiovascular system,increased sympathetic excitability,and weakened respiratory reflexes during REM sleep may make REM-OSAHS have greater health risks and more important clinical significance than NREM-OSAHS.Therefore,REM-OSAHS is in urgent need of widespread recognition and research in clinic.This paper reviews the clinical significance and therapeutic aspects of REM-OSAHS in recent years,and further considers the diagnosis and treatment of REM-OSAHS,aiming at deepening clinicians understanding of REM-OSAHS,facilitating early diagnosis and treatment,and providing reference for related research.