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염증 반응과 수면 장애

Inflammation and Insufficient or Disordered Sleep

김진관|이석준
대한임상검사과학회 (Korean Society for Clinical Laboratory Science)|2015.09|대한임상검사과학회지 (Korean Journal of Clinical Laboratory Science)|제47권 제3호|pp. 97-104

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참고문헌

키워드

ObesityInflammationObstructive sleep apneaInsufficient sleep
주제분류기타자연과학

초록

수면현상은 인간의 삶의 1/3을 차지하는 중요한 생리적 현상으로 인간의 수면은 신체의 기능을 유지하기 위한 중요한 생리적 기능뿐 아니라 수면을 통한 휴식을 통하여 신체 건강을 유지하고 성장을 유지하는 중요한 역할을 한다. 최근의 급격한 산업화와 정보화로 인하여 급격한 사회 생활구조의 변화를 유발하여 성인뿐 아니라 소아에서도 평균수면 시간의 감소와 다양한 스트레스 환경으로 인한 수면의 질적 저하로 인한 다양한 수면 문제가 사회적 문제로 대두되고 있다. 단순히 수면 부족 또는 수면의 질적 저하뿐 아니라 수면 장애, 특히 폐쇄성 수면 무호흡증은 심혈관 질환뿐 아니라 비만, 대사증후군, 심혈관 질환, 뇌혈관 질환 등 의 다양한 만성 질병의 발생과 깊은 연관성이 있는 것으로 보고하고 있다. 특히 이러한 만성질환을 유발하는 핵심기전으로 염증 반응이 관여하고 있는 것으로 알려져 있으며, 따라서 수면 현상과 다양한 수면 장애에 대한 관심이 급격히 증가하고 있는 실정이다. 비록 수면 무호흡증으로 인한 이러한 질병의 이환에 대한 기전은 다양한 요인이 복합적으로 작용하는 것으로 알려져 있지만 핵심 기전으로 알려진 염증반응의 활성화가 병태 생리학적으로 중요한 역할을 하는 것으로 추측하고 있다. 따라서 최근 수면 무호흡증을 낮은 수준의 만성 염증 질환으로 인식되고 있으며, 더불어 비만과 수면무호흡증으로 인한 연관된 질병의 이환을 더욱 증가시키는 것으로 보고되고 있다. 따라서 본 종설에는 수면의 질적 또는 양적 저하뿐 아니라 폐쇄성 수면 무호흡증으로 인한 염증성 반응의 활성화가 인간의 신체 면역 과정 미치는 영향을 중심으로 최근의 연구 결과 및 수면 무호흡증과 비만의 잠재적 상호작용에 대하여 서술하고자 한다.

Abstract

Sleep is not only an essential physiological function, but also serves important roles in promoting growth, maturation, and overall health of humans. There is increasing interest regarding the impact of sleep and its disorders on the regulation of inflammatory processes and end-organ morbidities, particularly in the context of metabolic and cardiovascular diseases (CVD) and their complications. Obstructive sleep apnea syndrome (OSAS) is an increasingly common health problem in children. In the last decade, the emergence of increasing obesity rates has further led to remarkable increases in the prevalence of OSAS, along with more prominent neurocognitive, behavioral, cardiovascular and metabolic morbidities. Although the underlying mechanisms leading to OSAS-induced morbidities are likely multifactorial and remain to be fully elucidated, activation of inflammatory pathways by OSAS has emerged as an important pathophysiological component of the end-organ injury associated with this disorder. To this effect, it would appear that OSAS could be viewed as a chronic, low-grade inflammatory disorder. Furthermore, the concurrent presence of obesity and OSAS poses a theoretically increased risk of OSAS-related complications. In this study, we will critically review the current state of research regarding the impact of insufficient and disrupted sleep and OSAS on the immune processes and inflammatory pathways that underlie childhood OSAS as a distinctive systemic inflammatory condition in children, and will explore potential interactions between OSAS and obesity.

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