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Obstructive Sleep Apnoea Syndrome and Weight Loss: Review

机译：阻塞性睡眠呼吸暂停综合症和体重减轻：综述

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Obstructive sleep apnoea (OSA) syndrome is common, and obesity is a major risk factor. Increased peripharyngeal and central adiposity result in increased pharyngeal collapsibility, through increased mechanical loading around the upper airway, reduced tracheal traction on the pharynx, and reduced neuromuscular activity, particularly during sleep. Significant and sustained weight loss, if achieved, is likely to be a useful therapeutic option in the management of OSA and may be attempted by behavioural, pharmacological, and surgical approaches. Behavioural therapy programs that focus on aspects such as dietary intervention, exercise prescription patients and general lifestyle counselling have been tested. Bariatric surgery is an option in the severely obese when nonsurgical measures have failed, and laparoscopic adjustable gastric banding and Roux-en-Y gastric bypass are the most commonly employed techniques in the United Kingdom. Most evidence for efficacy of surgery comes from cohort studies. The role of sibutramine in OSA in the obese patients has been investigated, however, there are concerns regarding associated cardiovascular risk. In this paper the links between obesity and OSA are discussed, and the recent studies evaluating the behavioural, pharmacological and surgical approaches to weight loss in OSA are reviewed.
机译：阻塞性睡眠呼吸暂停（OSA）综合征很常见，肥胖是主要的危险因素。咽周围和中央肥胖的增加导致咽部可折叠性的增加，这是通过增加上呼吸道周围的机械负荷，减少咽部上的气管牵引力以及减少神经肌肉活动（尤其是在睡眠过程中）引起的。如果实现显着且持续的体重减轻，可能是OSA管理中的一种有用的治疗选择，并且可以通过行为，药理和手术方法进行尝试。已经测试了针对饮食干预，运动处方患者和一般生活方式咨询等方面的行为疗法计划。在非手术措施失败的情况下，对于严重肥胖的人，减肥手术是一种选择，而腹腔镜可调式胃绑扎术和Roux-en-Y胃旁路术是英国最常用的技术。手术效果的大多数证据来自队列研究。已经研究了西布曲明在肥胖患者的OSA中的作用，但是，相关的心血管风险令人担忧。本文讨论了肥胖与OSA之间的联系，并综述了评估OSA减肥的行为，药理和手术方法的最新研究。

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