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폐쇄성 수면 무호흡의 합병증

Complications of Obstructive Sleep Apnea

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대한내과학회 (The Korean Association Of Internal Medicine)|2015.07|대한내과학회지 (The Korean Journal of Medicine)|제89권 제1호|pp. 13-20|DOI http://dx.doi.org/10.3904/kjm.2015.89.1.13

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키워드

합병증ComplicationSleep apnea폐쇄성 수면 무호흡Obstructive
주제분류내과학

초록

폐쇄성 수면 무호흡은 예전부터 있어온 오래된 질환이지만의학적으로 질환의 정체성이 확립된 것은 불과 40여 년에 지나지 않는다. 1981년에 실제적인 치료방법인 지속적 양압치료(CPAP)가 개발되고 많은 진전이 있었다. 폐쇄성 수면 무호흡으로 인해 생기는 저산소증/재관류 손상은 산화 스트레스와 함께 전신성 염증 반응을 일으키고 동반되는 심한 흉곽음압의 발생은 심혈관계에 심한 타격을 주어 결국에는 고혈압, 심부전, 뇌졸중, 관상동맥 질환, 부정맥, 폐고혈압, 당뇨병, 발기부전뿐 아니라 텔로미어의 단축이나 암발생의 증가 같은합병증을 일으킨다. 그리고 폐쇄성 수면 무호흡에 의해 일어나는 수면의 질 저하로 인해 주간졸림증이 심하게 되어 교통사고의 위험을 증가시켜 사회적 비용을 치르게 한다. 따라서폐쇄성 수면 무호흡의 진단과 치료 교육에 내과의사의 역할이 더욱 중요해지고 있다.

Abstract

While obstructive sleep apnea is a well-known sleep disorder, undiagnosed and untreated patients are an enormous burden in Korea. An episode of obstructive sleep apnea can induce dramatic changes in hemodynamics, leading to desaturation/reperfusion injury. Many complications follow episodes of obstructive sleep apnea and result in cardiovascular and other diseases, such as hypertension, heart failure, stroke, coronary artery disease, arrhythmias, pulmonary hypertension, diabetes mellitus, impotence, and even cancer mortality. Consequently, the role of physicians in detecting, treating, and educating patients about obstructive sleep apnea becomes more important.

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