Нарушения дыхания во сне и их влияние на течение хронических неинфекционных заболеваний легких

В лекции обобщены и проанализированы результаты исследований, касающихся изучения влияния нарушений дыхания во сне (НДС) на течение наиболее распространенных хронических неинфекционных заболеваний легких (ХНЗЛ). Нарушения дыхания во сне, такие как храп, синдром гиповентиляции во сне, синдром обструктивного и центрального апноэ сна, представляют собой актуальную медицинскую проблему ввиду их высокой распространенности и неблагоприятных последствий для здоровья. Нарушения дыхания во сне рассматриваются как независимый фактор риска развития и прогрессирования целого ряда ХНЗЛ. Своевременная диагностика и коррекция НДС может быть эффективной мерой профилактики тяжелого течения и осложнений этой группы заболеваний.

1. Чазова И.Е., Литвин А.Ю. Синдром обструктивного апноэ во время сна и связанные с ним сердечно-сосудистые осложнения. Российский кардиологический журнал. 2006;(1):75–86.

2. Damianaki A., Vagiakis E., Sigala I., Pataka A., Rovina N., Vlachou A. et al. Τhe co-existence of obstructive sleep apnea and bronchial asthma: revelation of a new asthma phenotype? J. Clin. Med. 2019;8(9):1476. DOI: 10.3390/jcm8091476.

3. Горбунова М.В., Бабак С.Л., Малявин А.Г. Рациональная антигипертензивная терапия пациентов с обструктивным апноэ сна. Архивъ внутренней медицины. 2019;9:85–92. DOI: 10.20514/2226-6704-2019-9-2-85-92.

4. Драпкина О.М., Концевая А.В., Калинина А.М., Авдеев С.Н., Агальцов М.В., Алексеева Л.И. и др. Коморбидность пациентов с хроническими неинфекционными заболеваниями в практике врача-терапевта. Евразийское руководство. Кардиоваскулярная терапия и профилактика. 2024;23(3):3996. DOI: 10.15829/1728-8800-2024-3996.

5. Bradley T.D., Floras J.S. Obstructive sleep apnoea and its cardiovascular consequences. Lancet. 2009;373(9657):82–93. DOI: 10.1016/S0140-6736(08)61622-0.

6. Johnson K.G., Johnson D.C. Frequency of sleep apnea in stroke and TIA patients: a meta-analysis. J. Clin. Sleep Med. 2010;6(2):131–137.

7. Литвин А.Ю., Чазова И.Е., Галяви Р.А. Обструктивное апноэ сна и метаболический синдром. Доктор.Ру. 2007;(4):5–9.

8. Крюков А.И., Кунельская Н.Л., Тардов М.В., Ивойлов А.Ю., Царапкин Г.Ю., Болдин А.В. и др. Синдром обструктивного апноэ сна: диагностика и консервативное лечение. Позиция невролога. Методические рекомендации. М., 2020:25.

9. Беспалова И.Д., Рязанцева Н.В., Калюжин В.В., Мурашев Б.Ю., Осихов И.А., Медянцев Ю.А. Влияние аторвастатина на провоспалительный статус (in vivo и in vitro) больных гипертонической болезнью с метаболическим синдромом. Кардиология. 2014;54(8):37–43. DOI: 10.18565/cardio.2014.8.37-43.

10. Беспалова И.Д., Бычков В.А., Калюжин В.В., Рязанцева Н.В., Медянцев Ю.А., Осихов И.А., Мурашев Б.Ю. Качество жизни больных гипертонической болезнью с метаболическим синдромом: взаимосвязь с маркерами системного воспаления. Бюллетень сибирской медицины. 2013;12(6):5–11.

11. Larsson L.G., Lindberg A., Franklin K.A., Lundbäck B. Obstructive Lung Disease in Northern Sweden Studies. Obstructive sleep apnea syndrome is common in subjects with chronic bronchitis. Report from the Obstructive Lung Disease in Northern Sweden studies. Respiration. 2001;68:250–255.

12. Teodorescu M., Consens F.B., Bria W.F., Coffey M.J., Mc Morris M.S., Weatherwax K. et al. Correlates of daytime sleepiness in patients with asthma. Sleep Med. 2006;7:607–613.

13. Gan Q., Liu Q., Wu Y., Zhu X., Wang J., Su X. et al. The Causal Association Between Obstructive Sleep Apnea and Child-Onset Asthma Come to Light: A Mendelian Randomization Study. Nat. Sci. Sleep. 2024;16:979–987. DOI: 10.2147/NSS.S472014.

14. Alharbi M., Almutairi A., Alotaibi D., Alotaibi A., Shaikh S., Bahammam A.S. The prevalence of asthma in patients with obstructive sleep apnoea. Prim. Care Respir. J. 2009;18(4):328–330. DOI: 10.4104/pcrj.2009.00020.

15. Damianaki A., Vagiakis E., Sigala I., Pataka A., Rovina N., Vlachou A. et al. Τhe co-existence of obstructive sleep apnea and bronchial asthma: revelation of a new asthma phenotype? J. Clin. Med. 2019;8(9):1476. DOI: 10.3390/jcm8091476.

16. Taillé C., Rouvel-Tallec A., Stoica M., Danel C., Dehoux M., Marin-Esteban V. et al. Obstructive sleep apnoea modulates airway inflammation and remodelling in severe asthma. PLoS One. 2016;11:e0150042.

17. Broytman O., Braun R.K., Morgan B.J., Pegelow D.F., Hsu P.N., Mei L.S. et al. Effects of chronic intermittent hypoxia on allergen-induced airway inflammation in rats. Am. J. Respir. Cell Mol. Biol. 2015;52:162–170.

18. Yigla M., Tov N., Solomonov A., Rubin A.H., Harlev D. Difficult-to-control asthma and obstructive sleep apnea. J. Asthma. 2003;40:865–871.

19. Togias A. Rhinitis and asthma: Evidence for respiratory system integration. J. Allergy Clin. Immunol. 2003;111:1171–1183.

20. Sano A., Kozuka T., Watatani N., Kunita Y. Kawabata Y., Gose K. et al. Role of bronchial hyperresponsiveness in patients with obstructive sleep apnea with asthma-like symptoms. Allergol. Int. 2024;73(2):231–235. DOI: 10.1016/j.alit.2023.10.006.

21. Ragnoli B., Pochetti P., Raie A., Malerba M. Interrelationship between obstructive sleep apnea syndrome and severe asthma: from endo-phenotype to clinical aspects. Front. Med. (Lausanne). 2021;8:640636. DOI: 10.3389/fmed.2021.640636.

22. Hirayama A., Goto T., Faridi M.K., Camargo C.A. Jr., Hasegawa K. Association of obstructive sleep apnea with all-cause readmissions after hospitalization for asthma exacerbation in adults aged 18–54 years: a population-based study, 2010–2013. J. Asthma. 2021;58(9):1176–1185. DOI: 10.1080/02770903.2020.1781887.

23. D’Cruz R.F., Murphy P.B., Kaltsakas G. Sleep disordered breathing and chronic obstructive pulmonary disease: a narrative review on classification, pathophysiology and clinical outcomes. J. Thorac. Dis. 2020;12(Suppl. 2):S202–S216. DOI: 10.21037/jtd-cus-2020-006.

24. McNicholas W.T. COPD-OSA overlap syndrome: evolving evidence regarding epidemiology, clinical consequences, and management. Chest. 2017;152(6):1318–1326. DOI: 10.1016/j.chest.2017.04.160.

25. Shawon M.S., Perret J.L., Senaratna C.V., Lodge C., Hamilton G.S., Dharmage S.C. Current evidence on prevalence and clinical outcomes of co-morbid obstructive sleep apnea and chronic obstructive pulmonary disease: A systematic review. Sleep Med. Rev. 2017;32:58–68. DOI: 10.1016/j.smrv.2016.02.007.

26. Brennan M., McDonnell M.J., Walsh S.M., Gargoum F., Rutherford R. Review of the prevalence, pathogenesis and management of OSA-COPD overlap. Sleep Breath. 2022;26(4):1551–1560. DOI: 10.1007/s11325-021-02540-8.

27. McNicholas W.T. Does associated chronic obstructive pulmonary disease increase morbidity and mortality in obstructive sleep apnea? Ann. Am. Thorac. Soc. 2019;16(1):50–53. DOI: 10.1513/AnnalsATS.201809-628ED.

28. O’Neill E., Ryan S., McNicholas W.T. Chronic obstructive pulmonary disease and obstructive sleep apnoea overlap: co-existence, co-morbidity, or causality? Curr. Opin. Pulm. Med. 2022;28(6):543–551. DOI: 10.1097/MCP.0000000000000922.

29. McSharry D.G., Ryan S., Calverley P., Edwards J.C., McNicholas W.T. Sleep quality in chronic obstructive pulmonary disease. Respirology. 2012;17:1119–1124.

30. Voulgaris A., Archontogeorgis K., Steiropoulos P., Papanas N. Cardiovascular disease in patients with chronic obstructive pulmonary disease, obstructive sleep apnoea syndrome and overlap syndrome. Curr. Vasc. Pharmacol. 2021;19(3):285–300. DOI: 10.2174/1570161118666200318103553.

31. Crinion S.J., Ryan S., McNicholas W.T. Obstructive sleep apnoea as a cause of nocturnal nondipping blood pressure: recent evidence regarding clinical importance and underlying mechanisms. Eur. Respir. J. 2017;49:1601818.

32. Ganga H.V., Nair S.U., Puppala V.K., Miller W.L. Risk of new-onset atrial fibrillation in elderly patients with the overlap syndrome: a retrospective cohort study. J. Geriatr. Cardiol. 2013;10:129–134.

33. Castro-Grattoni A.L., Alvarez-Buvé R., Torres M., Farré R., Montserrat J.M., Dalmases M. et al. Intermittent hypoxia-induced cardiovascular remodeling is reversed by normoxia in a mouse model of sleep apnea. Chest. 2016;149:1400–1408.

34. Ражабов Х.С., Ливерко И.В. Прогноз течения хронической обструктивной болезни легких с синдромом обструктивного апноэ ‒ гипопноэ сна. Туберкулез и болезни легких. 2022;100(7):22–27. DOI: 10.21292/2075-1230-2022-100-7-22-27.

35. Vaidya S., Gothi D., Patro M. COPD sleep phenotypes: genesis of respiratory failure in COPD. Monaldi Arch. Chest Dis. 2021;92(2). DOI: 10.4081/monaldi.2021.1776.

36. Suri T.M., Suri J.C. A review of therapies for the overlap syndrome of obstructive sleep apnea and chronic obstructive pulmonary disease. FASEB Bioadv. 2021;3(9):683–693. DOI: 10.1096/fba.2021-00024.

37. Soler X., Gaio E., Powell F.L., Ramsdell J.W., Loredo J.S., Malhotra A., Ries A.L. High prevalence of obstructive sleep apnea in patients with moderate to severe chronic obstructive pulmonary disease. Ann. Am. Thorac. Soc. 2015;12(9):1420–1421. DOI: 10.1513/AnnalsATS.201506-379LE.

38. Troy L.K., Corte T.J. Sleep disordered breathing in interstitial lung disease: A review. World J. Clin. Cases. 2014;2(12):828–834. DOI: 10.12998/wjcc.v2.i12.828.

39. Nasser M., Larrieu S., Si-Mohamed S., Ahmad K., Boussel L., Brevet M. et al. Progressive fibrosing interstitial lung disease: a clinical cohort (the PROGRESS study). Eur. Respir. J. 2021;57(2):2002718. DOI: 10.1183/13993003.02718-2020.

40. Du Bois R.M., Weycker D., Albera C., Bradford W.Z., Costabel U., Kartashov A. et al. Ascertainment of individual risk of mortality for patients with idiopathic pulmonary fibrosis. Am. J. Respir. Crit. Care Med. 2011;184(4):459–466. DOI: 10.1164/rccm.201011-1790OC.

41. Laz N.I., Mohammad M.F., Srour M.M., Arafat W.R. Study of the prevalence and predictive factors of sleep-disordered breathing in patients with interstitial lung diseases. Egypt J. Bronchol. 2024;18:11. DOI: 10.1186/s43168-024-00264-3.

42. Valecchi D., Bargagli E., Pieroni M.G., Refini M.R., Sestini P., Rottoli P., Melani A.S. Prognostic significance of obstructive sleep apnea in a population of subjects with interstitial lung diseases. Pulm. Ther. 2023;9(2):223–236. DOI: 10.1007/s41030-023-00215-1.

43. Myall K.J., West A.G., Martinovic J.L., Lam J.L., Roque D., Wu Z. et al. Nocturnal Hypoxemia associates with symptom progression and mortality in patients with progressive fibrotic interstitial lung disease. Chest. 2023;164(5):1232–1242. DOI: 10.1016/j.chest.2023.05.013.

44. Bordas-Martinez J., Salord N., Vicens-Zygmunt V., Carmezim J., Pérez S. et al. Treating sleep-disordered breathing of idiopathic pulmonary fibrosis patients with CPAP and nocturnal oxygen treatment. A pilot study: Sleep-disordered breathing treatment in IPF. Respir. Res. 2024;25(1):247. DOI: 10.1186/s12931-024-02871-6.

45. Gozal D., Farré R., Nieto F.J. Obstructive sleep apnea and cancer: Epidemiologic links and theoretical biological constructs. Sleep Med. Rev. 2016;27:43–55. DOI: 10.1016/j.smrv.2015.05.006.

46. Gueye-Ndiaye S., Williamson A.A., Redline S. Disparities in sleep-disordered breathing: upstream risk factors, mechanisms, and implications. Clin. Chest Med. 2023;44(3):585–603. DOI: 10.1016/j.ccm.2023.03.012.

47. Almendros I., Gozal D. Intermittent hypoxia and cancer: Undesirable bed partners? Respir. Physiol. Neurobiol. 2018;256:79–86. DOI: 10.1016/j.resp.2017.08.008.

48. Nieto F.J., Peppard P.E., Young T., Finn L., Hla K.M., Farré R. Sleep-disordered breathing and cancer mortality: results from the Wisconsin Sleep Cohort Study. Am. J. Respir. Crit. Care Med. 2012;186(2):190–194. DOI: 10.1164/rccm.201201-0130OC.

49. Marshall N.S., Wong K.K., Cullen S.R., Knuiman M.W., Grunstein R.R. Sleep apnea and 20-year follow-up for allcause mortality, stroke, and cancer incidence and mortality in the Busselton Health Study cohort. J. Clin. Sleep Med. 2014;10(4):355–362. DOI: 10.5664/jcsm.3600.

50. Brenner R., Kivity S., Peker M., Reinhorn D., Keinan-Boker L., Silverman B. et al. Increased risk for cancer in young patients with severe obstructive sleep apnea. Respiration. 2019;97(1):15–23. DOI: 10.1159/000486577.

51. Kendzerska T., Povitz M., Leung R.S., Boulos M.I., McIsaac D.I., Murray B.J. et al. Obstructive Sleep Apnea and Incident Cancer: A Large Retrospective Multicenter Clinical Cohort Study. Cancer Epidemiol. Biomarkers Prev. 2021;30(2):295–304. DOI: 10.1158/1055-9965.EPI-20-0975.

52. Cheong A.J.Y., Tan B.K.J., Teo Y.H., Tan N.K.W., Yap D.W.T., Sia C.H. et al. Obstructive Sleep Apnea and Lung Cancer: A Systematic Review and Meta-Analysis. Ann. Am. Thorac. Soc. 2022;19(3):469–475. DOI: 10.1513/AnnalsATS.202108-960OC.

53. Cao Y., Ning P., Li Q., Wu S. Cancer and obstructive sleep apnea: An updated meta-analysis. Medicine (Baltimore). 2022;101(10):e28930. DOI: 10.1097/MD.0000000000028930.

54. Cabezas E., Pérez-Warnisher M.T., Troncoso M.F., Gómez T., Melchor R., Pinillos E.J. et al. Sleep Disordered Breathing Is Highly Prevalent in Patients with Lung Cancer: Results of the Sleep Apnea in Lung Cancer Study. Respiration. 2019;97(2):119–124. DOI: 10.1159/000492273.

55. Bhaisare S., Gupta R., Saini J., Chakraborti A., Khot S. Sleep-disordered breathing in newly diagnosed patients of lung cancer. Cureus. 2022;14(5):e25230. DOI: 10.7759/cureus.25230.

56. Seifen C., Huppertz T., Matthias C., Gouveris H. Obstructive Sleep apnea in patients with head and neck cancer-more than just a comorbidity? Medicina (Kaunas). 2021;57(11):1174. DOI: 10.3390/medicina57111174.

57. Inoshita A., Sata N., Ohba S., Suzuki Y., Ito S., Shiroshita N. et al. Impact of radiotherapy for head and neck cancer on obstructive sleep apnea: a prospective study. Ann. Palliat. Med. 2022;11(8):2631–2640. DOI: 10.21037/apm-22-267.

58. Huppertz T., Horstmann V., Scharnow C., Ruckes C., Bahr K., Matthias C. et al. OSA in patients with head and neck cancer is associated with cancer size and oncologic outcome. Eur. Arch. Otorhinolaryngol. 2021;278(7):2485–2491. DOI: 10.1007/s00405-020-06355-3.

59. Alaoui A.A., Alaoui S., Hajjar R., Urso D., Gnoni V. Head and neck cancer radiotherapy and obstructive sleep apnea. Ann. Palliat. Med. 2022;11(12):3592–3595. DOI: 10.21037/apm-22-972.