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Auswirkungen der Schlafapnoe auf andere Organsysteme

Sleep apnea and organ damage

  • Leitthema
  • Published:
Der Pneumologe Aims and scope

Zusammenfassung

Die obstruktive Schlafapnoe zeichnet sich durch repetitive Apnoen und Hypopnoen in Verbindung mit Atemanstrengungen gegen einen kollabierten Pharynx aus. Zu den unmittelbaren Folgen der Apnoen und Hypopnoen gehören Hypoxie, Aufwachreaktionen und apnoesynchrone Anstiege der Sympathikusaktivität, der Herzfrequenz sowie des arteriellen und pulmonalarteriellen Blutdruckes. Der vorliegende Beitrag erläutert die längerfristigen pathophysiologischen Konsequenzen der obstruktiven Schlafapnoe wie u. a. arterielle Hypertonie, endotheliale Dysfunktion, Begünstigung einer diabetischen Stoffwechsellage und Akzeleration der Atherosklerose, die bei Patienten mit schwerer Schlafapnoe letztlich zu einem etwa 3-fach erhöhten Risiko für einen Myokardinfarkt oder einen Schlaganfall beitragen. Weiterhin wird die Rolle der Schlafapnoe bei der Entstehung und Progression der Herzinsuffizienz beschrieben.

Abstract

Obstructive sleep apnea is characterized by repetitive apneas and hypopneas and respiratory efforts against the occluded pharynx. Its immediate pathophysiological sequelae include hypoxia, arousal from sleep, and repetitive surges of sympathetic activity, heart rate an arterial as well as pulmonary arterial pressure. This report outlines the long-term pathophysiological consequences of obstructive sleep apnea (e.g. hypertension, endothelial dysfunction, metabolic dysregulation and acceleration of atherosclerosis), which ultimately contribute to a threefold increase in the risk of cardio and cerebrovascular diseases such as myocardial infarction and stroke in patients with severe sleep apnea. Moreover, the role of sleep apnea in promoting the progression of heart failure is described.

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Abbreviations

AHI:

Apnoe-Hypopnoe-Index

CPAP:

„Continuous positive airway pressure“

CSA:

Zentrale Schlafapnoe

OSA:

Obstruktive Schlafapnoe

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Authors and Affiliations

  1. Klinik und Poliklinik für Innere Medizin II, Pneumologie, Klinikum der Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93042, Regensburg, Deutschland

    M. Arzt & M. Pfeifer

  2. Zentrum für Pneumologie, Psychosomatische Medizin und Psychotherapie, Klinik Donaustauf, Donaustauf, Deutschland

    M. Pfeifer

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  1. M. Arzt
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Correspondence to M. Arzt.

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Arzt, M., Pfeifer, M. Auswirkungen der Schlafapnoe auf andere Organsysteme. Pneumologe 4, 85–94 (2007). https://doi.org/10.1007/s10405-007-0140-5

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  • DOI: https://doi.org/10.1007/s10405-007-0140-5

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