Síndrome da Apneia Obstrutiva do Sono e Doenças Cardiovasculares

Autores

  • Daniella D. Azzari Campostrini Neurologista, residente de Neurofisiologia Clínica da EPM-UNIFESP, São Paulo-SP, Brasil.
  • Lucila B. Fernandes do Prado Neurofisiologista com atuação em Medicina do Sono, Doutora, Setor de Neuro-Sono da Disciplina de Neurologia da EPM-UNIFESP, São Paulo-SP, Brasil.
  • Gilmar Fernandes do Prado Neurologista, Doutor, Professor Livre Docente, Setor de Neuro-Sono da Disciplina de Neurologia da EPM-UNIFESP, São Paulo-SP, Brasil

DOI:

https://doi.org/10.34024/rnc.2014.v22.8127

Palavras-chave:

Síndrome da Apneia Obstrutiva do Sono, Doenças Cardiovasculares, Hipertensão, insuficiência Cardíaca Congestiva, Doença da Artéria Coronariana, Arritmias Cardíacas

Resumo

Introdução. A Síndrome da Apneia Obstrutiva do Sono (SAOS) é caracterizada por obstrução parcial ou completa da via aérea superior, de forma intermitente e recorrente durante o sono. As principais ma­nifestações durante o sono incluem roncos, pausas respiratórias, frag­mentação do sono, levando a prejuízos diurnos incapacitantes, como sonolência excessiva diurna, alterações cognitivas e cefaléia matinal. Além das manifestações respiratórias clássicas, resulta em alterações metabólicas e hemodinâmicas que predispõem ao desenvolvimento e agravamento de doenças cardiovasculares, tais como hipertensão arterial sistêmica, insuficiência cardíaca congestiva, doença arterial coronariana e arritmias. Objetivo. Abordar aspectos clínicos, fisiopa­tológicos e diagnósticos da SAOS, bem como seus efeitos deletérios no sistema cardiovascular. Método. Revisão da literatura acerca da SAOS e suas consequências cardiovasculares através de artigos sele­cionados no PubMed. Conclusão. A apneia obstrutiva do sono e as doenças cardiovasculares têm origem multifatorial e alta prevalência na população mundial. Considerando que as doenças cardiovasculares são a maior causa atual de morbidade e mortalidade no mundo, a determinação de fatores de risco possíveis de controle e tratamento, como a SAOS, torna-se fundamental para prevenção e tratamento das doenças cardiovasculares.

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Referências

Hersi AS. Obstructive sleep apnea and cardiac arrhythmias. Ann Thorac Med 2010;5:10-7. http://dx.doi.org/10.4103/1817-1737.58954

Kryger MH, Roth T, Dement WC (eds.). Principles of Sleep Medicine. St. Louis: Elsevier Saunders, 5th edition, 2011, 1928p.

Chan KH, Wilcox I. Obstructive sleep apnea: novel trigger and potential therapeutic target for cardiac arrhythmias. Expert Rev Cardiovasc Ther 2010;8:981-94. http://dx.doi.org/10.1586/erc.10.80

Murray CJL, Lopez AD. The global burden of disease: a comprehensive assessment of mortality and disability from disease, injuries and risk factors in 1990 and projected to 2020. Harvard: Harvard Univeresity Press, 1996, 43p.

Lolio CA, Laurenti R. Evolução da mortalidade por doença isquêmica do coração no município de São Paulo, 1970 a 1981. Arq Bras Cardiol 1986;46:153-6.

Uemura K, Pisa Z. Recent trends in cardiovascular disease mortality in 27 industrialized countries. Wld Hlth Start Quart 1971;38:1617-25.

Kingshott RN, Sime PJ, Engleman HM, Douglas NJ. Self assessment of daytime sleepiness: patient versus partner. Thorax 1995;50:994-5. http://dx.doi.org/10.1136/thx.50.9.994

Gottieb DJ, Yao Q, Redline S, Ali T, Mahowald MW. Does snoring predicte sleepiness independently of apnea and hypopnea frequency? Am J Respir Crit Care Med 2000;162:1512-7. http://dx.doi.org/10.1164/ajrccm.162.4.9911073

Flemons WW, Whitelaw WA, Brant R, Remmers JE. Likelihood ratios for a sleep apnea clinical prediction rule. Am J Respir Crit Care Med 1994;150:1279-85. http://dx.doi.org/10.1164/ajrccm.150.5.7952553

Viner S, Szalai JP, Hoffstein V. Are history and physical examination a good screening test for sleep apnea? Ann Intern Med 1991;115:356-9. http://dx.doi.org/10.7326/0003-4819-115-5-356

Phillips BA, Kryger MH. Management of Obstructive Sleep Apnea-Hypopnea Syndrome. In: Kryger MH, Roth T, Dement WC (eds.). Principles of Sleep Medicine. St. Louis: Elsevier Saunders, 5th edition, 2011, p.827-37. http://dx.doi.org/10.1016/B978-1-4160-6645-3.00110-9 http://dx.doi.org/10.1016/B978-1-4160-6645-3.00134-1

Jamieson A GC, Partinen M, Quera-Salva MA. Obstructive sleep apneic patients have craniomandibular abnormalities. Sleep 1986; 9:469-77.

Iber C, Israel SA, Chesson AL, Quan SF. The AASM manual for the scoring of sleep and associated events: Rules, Terminology, and Technical specifications. Westchester: American Academy of Sleep Medicine, 2007, 59p.

Drager LF, Bortolotto LA, Maki-Nunes C, Trombetta IC, Alves MJ, Fraga RF, et al. The incremental role of obstructive sleep apnoea on markers of atherosclerosis in patients with metabolic syndrome. Atherosclerosis 2010;208:490-5. http://dx.doi.org/10.1016/j.atherosclerosis.2009.08.016

Drager LF, Krieger EM, Lorenzi-Filho G. Sympathetic Activity, Heart Failure, Obesity, and Metabolic Syndrome: Is There Any Role for Obstructive Sleep Apnea? Hypertension 2007;49:e38. http://dx.doi.org/10.1161/HYPERTENSIONAHA.107.090274

Strohl KP, Novak RD, Singer W, Cahan C, Boehm KD, Denko CW, et al. Insulin levels, blood pressure and sleep apnea. Sleep 1994;17:614-8.

McCord JM. Oxygen-derived free radicals in post-20. ischemic tissue injury. N Engl J Med 1985;312:159-63. http://dx.doi.org/10.1056/NEJM198501173120305

Findley LJ, Boykin M, Fallon T, Belardinelli L. Plasma adenosine and hypoxemia in patients with sleep apnea. J Appl Physiol 1988;64:556-61.

Vgontzas AN, Papanicolaou DA, Bixler EO. Elevation of plasma cytokines in disorders of excessive daytime sleepiness: role of sleep disturbance and obesity. J Clin Endocrinol Metab 1997;82:1313-6. http://dx.doi.org/10.1210/jcem.82.5.3950 http://dx.doi.org/10.1210/jc.82.5.1313

Baguette JP, Narkiewicz K, Mallion JM. Update on Hypertension Management: obstructive sleep apnea and hypertension. J Hypertens 2006;24:205-8. http://dx.doi.org/10.1097/01.hjh.0000198039.39504.63

Calhoun DA, Harding SM. SLeep and hypertension. Chest 2010;138:434- 43. http://dx.doi.org/10.1378/chest.09-2954

Asha’ari ZA, Hasmoni MH, Ab Rahman J, Yusof RA, Ahmad RA. The association between sleep apnea and young adults with hypertension. Laryngoscope 2012;122:2337-42. http://dx.doi.org/10.1002/lary.23379

Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 2000;342:1378-84. http://dx.doi.org/10.1056/NEJM200005113421901

Sociedade Brasileira de Nefrologia. VI Diretrizes Brasileiras de Hipertensão. Arq Bras Cardiol 2010; 95(1 supl.1):1-51.

Pimenta E, Stowasser M, Gordon RD, Harding SM, Batlouni M, Zhang B, et al. Increased dietary sodium is related to severity of obstructive sleep apnea in patients with resistant hypertension and hyperaldosteronism. Chest 2013;143:978-83. http://dx.doi.org/10.1378/chest.12-0802

Gonzaga CC, Gaddam KK, Ahmed MI, Pimenta E, Thomas SJ, Harding SM, et al. Severity of obstructive sleep apnea is related to aldosterone status in subjects with resistant hypertension. J Clin Sleep Med 2010;6:363-8.

Narkiewicz K, Somers VK. The sympathetic nervous system and obstructive sleep apnea: implications for hypertension. J Hypertens 1997;15:1613-9. http://dx.doi.org/10.1097/00004872-199715120-00062

Waradekar NV, Sinoway LI, Zwillich CW, Leuenberger UA. Influence oftreatment on muscle sympathetic nerve activity in sleep apnea. Am J Respir Crit Care Med 1996;153:1333-8. http://dx.doi.org/10.1164/ajrccm.153.4.8616563

Haentjens P, Van Meerhaeghe A, Moscariello A, De Weerdt S, Poppe K, Dupont A, et al. The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome: evidence from a meta-analysis of placebo-controlled randomized trials. Arch Intern Med 2007;167:757-64. http://dx.doi.org/10.1001/archinte.167.8.757

Dudenbostel T, Calhoun DA. Resistant hypertension, obstructive sleep apnoea and aldosterone. J Hum Hypertens 2012;26:281-7. http://dx.doi.org/10.1038/jhh.2011.47

Rao M, Rajda G, Uppuluri S, Beck GR, Liu L, Bisognano JD. The role of continuous positive airway pressure in the treatment of hypertension in patients with obstructive sleep apnea-hypoapnea syndrome: a review of randomized trials. Rev Recent Clin Trials 2010;5:35-42. http://dx.doi.org/10.2174/157488710790820526

Wang H, Parker JD, Newton GE, Floras JS, Mak S, Chiu KL, et al. Influence of obstructive sleep apnea on mortality in patients with heart failure. J Am Coll Cardiol 2007;49:1625-31. http://dx.doi.org/10.1016/j.jacc.2006.12.046

Javaheri S, Parker TJ, Liming JD, Corbett WS, Nishiyama H, Wexler L, et al. Sleep apnea in 81 ambulatory male patients with stable heart failure. Types and their prevalences, consequences, and presentations. Circulation 1998;97:2154-9. http://dx.doi.org/10.1161/01.CIR.97.21.2154

Sin DD, Fitzgerald F, Parker JD, Newton G, Floras JS, Bradley TD. Risk factors for central and obstructive sleep apnea in 450 men and women with congestive heart failure. Am J Respir Crit Care Med 1999;160:1101-6. http://dx.doi.org/10.1164/ajrccm.160.4.9903020

Shahar E, Whitney CW, Redline S, Lee ET, Newman AB, Javier Nieto F, et al. Seep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med 2001;163:19-25. http://dx.doi.org/10.1164/ajrccm.163.1.2001008

Otto ME, Belohlavek M, Romero-Corral A, Gami AS, Gilman G, Svatikova A, et al. Comparison of cardiac structural and functional changes in obese otherwise healthy adults with versus without obstructive sleep apnea. Am J Cardiol 2007;99:1298-302. http://dx.doi.org/10.1016/j.amjcard.2006.12.052 37.Fung JW, Li TS, Choy DK, Yip GW, Ko FW, Sanderson JE, et al. Severe obstructive sleep apnea is associated with left ventricular diastolic dysfunction. Chest 2002;121:422-9. http://dx.doi.org/10.1378/chest.121.2.422

Floras JS. Clinical aspects of sympathetic activation and parasympathetic withdrawal in heart failure. J Am Coll Cardiol 1993;22(4 Suppl A):72A-84. http://dx.doi.org/10.1016/0735-1097(93)90466-E

Roebuck T, Solin P, Kaye DM, Bergin P, Bailey M, Naughton MT. Increased long-term mortality in heart failure due to sleep apnoea is not yet proven. Eur Respir J 2004;23:735-40. http://dx.doi.org/10.1183/09031936.04.00060404

Wexler L, Javaheri S. Sleep apnea is linked to heart failure, but does treatment improve outcome? Cleve Clin J Med 2005;72:929-36. http://dx.doi.org/10.3949/ccjm.72.10.929

Mansfield DR, Gollogly NC, Kaye DM, Richardson M, Bergin P, Naughton MT. Controlled trial of continuous positive airway pressure in obstructive sleep apnea and heart failure. Am J Respir Crit Care Med 2004;169:361-6. http://dx.doi.org/10.1164/rccm.200306-752OC

Sajkov D, Wang T, Saunders NA, Bune AJ, McEvoy RD. Continuous positive airway pressure treatment improves pulmonary hemodynamics in patients with obstructive sleep apnea. Am J Respir Crit Care Med 2002;165:152-8. http://dx.doi.org/10.1164/ajrccm.165.2.2010092

Arias MA, Garcia-Rio F, Alonso-Fernandez A, Martinez I, Villamor J. Pulmonary hypertension in obstructive sleep apnoea: effects of continuous positive airway pressure: a randomized, controlled cross-over study. Eur Heart J 2006;27:1106-13. http://dx.doi.org/10.1093/eurheartj/ehi807

Monahan K, Storfer-Isser A, Mehra R, Shahar E, Mittleman M, Rottman J, et al. Triggering of nocturnal arrhythmias by sleep-disordered breathing events. Am Coll Cardiol 2009;54:1797-804. http://dx.doi.org/10.1016/j.jacc.2009.06.038

Mehra R, Benjamin EJ, Shahar E, Gottlieb DJ, Nawabit R, Kirchner HL, et al. Association of nocturnal arrhythmias with sleep-disordered breathing: The Sleep Heart Health Study. Am J Respir Crit Care Med 2006;173:910-6. http://dx.doi.org/10.1164/rccm.200509-1442OC

Miller WP. Cardiac arrhythmias and conduction disturbances in the sleep apnea syndrome. Prevalence and significance. Am J Med 1982;73:317-21. http://dx.doi.org/10.1016/0002-9343(82)90716-1

Gami AS, Pressman G, Caples SM, Kanagala R, Gard JJ, Davison DE, et al. Association of atrial fibrillation and obstructive sleep apnea. Circulation 2004;110:364-7. http://dx.doi.org/10.1161/01.CIR.0000136587.68725.8E

Wang TJ, Parise H, Levy D, D’Agostino RB, Wolf PA, Vasan RS, et al. Obesity and the risk of new-onset atrial fibrillation. JAMA 2004;292:2471-7. http://dx.doi.org/10.1001/jama.292.20.2471

Haggsträm FM ZE, Fam CF. Apnéia obstrutiva do sono e alterações cardiovasculares. Scientia Medica 2009;19:122-8.

Gami AS, Howard DE, Olson EJ, Somers VK. Day-night pattern of sudden death in obstructive sleep apnea. N Engl J Med 2005;352:1206-14. http://dx.doi.org/10.1056/NEJMoa041832

Harbison J, O’Reilly P, McNicholas WT. Cardiac rhythm disturbances in the obstructive sleep apnea syndrome: effects of nasal continuous positive airway pressure therapy. Chest 2000;118:591-5. http://dx.doi.org/10.1378/chest.118.3.591

Abe H, Takahashi M, Yaegashi H, Eda S, Tsunemoto H, Kamikozawa M, et al. Efficacy of continuous positive airway pressure on arrhythmias in obstructive sleep apnea patients. Heart Vessels 2010;25:63-9. http://dx.doi.org/10.1007/s00380-009-1164-z

Ng CY, Liu T, Shehata M, Stevens S, Chugh SS, Wang X. Meta-analysis of obstructive sleep apnea as predictor of atrial fibrillation recurrence after catheter ablation. Am J Cardiol 2011;108:47-51. http://dx.doi.org/10.1016/j.amjcard.2011.02.343

Patel D, Mohanty P, Di Biase L, Shaheen M, Lewis WR, Quan K, et al. Safety and efficacy of pulmonary vein antral isolation in patients with obstructive sleep apnea: the impact of continuous positive airway pressure. Circ Arrhythm Electrophysiol 2010;3:445-51. http://dx.doi.org/10.1161/CIRCEP.109.858381

Carlson JT, Hedner J, Elam M, Ejnell H, Sellgren J, Wallin BG. Augmented resting sympathetic activity in awake patients with obstructive sleep apnea. Chest 1993;103:1763-8. http://dx.doi.org/10.1378/chest.103.6.1763

Somers VK, White DP, Amin R, Abraham WT, Costa F, Culebras A, et al. Sleep apnea and cardiovascular disease: an American Heart Association/ american College Of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council,

and Council On Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). Circulation 2008;118:1080-111. http://dx.doi.org/10.1161/CIRCULATIONAHA.107.189420

Kato M, Roberts-Thomson P, Phillips BG, Haynes WG, Winnicki M, Accurso V, et al. Impairment of endothelium-dependent vasodilatation of resistence vassels in patients with obstructive sleep apnea. Circulation 2000;102:207-10. http://dx.doi.org/10.1161/01.CIR.102.21.2607

Epstein LJ, Kristo D, Strollo PJ, Friedman N, Malhotra A, Patil SP, et al. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 2009;5:263-76. 59.Rosenthal L, Massie CA, Dolan DC, Loomas B, Kram J, Hart RW. A multicenter, prospective study of a novel nasal EPAP device in the treatment of obstructive sleep apnea: efficacy and 30-day adherence. J Clin Sleep Med 2009;5:532-7.

Vennelle M, White S, Riha RL, Mackay TW, Engleman HM, Douglas NJ. Randomized controlled trial of variable-pressure versus fixed-pressure continuous positive airway pressure (CPAP) treatment for patients with obstructive sleep pnea/hypopnea syndrome (OSAHS). Sleep 2010;33:267-71.

McNicholas WT. Cardiovascular outcomes of CPAP therapy in obstructive sleep apnea syndrome. Am J Physiol Regul Integr Comp Physiol 2007;293:1666-70. http://dx.doi.org/10.1152/ajpregu.00401.2007

Aloia MS, Knoepke CE, Lee-Chiong T. The new local coverage determination criteria for adherence to positive airway pressure treatment: testing the limits? Chest 2010;138:875-9. http://dx.doi.org/10.1378/chest.09-2237

Hoffstein V. Review of oral appliances for treatment of sleep-disordered breathing. Sleep Breath 2007;11:1-22. http://dx.doi.org/10.1007/s11325-006-0084-8

Elshaug AG, Moss JR, Southcott AM, Hiller JE. Redefining success in airway surgery for obstructive sleep apnea: a meta analysis and synthesis of the evidence. Sleep 2007;30:461-7.

Li HY, Wang PC, Chen YP, Lee LA, Fang TJ, Lin HC. Critical appraisal and meta-analysis of nasal surgery for obstructive sleep apnea. Am J Rhinol Allergy 2011;25:45-9. http://dx.doi.org/10.2500/ajra.2011.25.3558

Peker Y, Carlson J, Hedner J. Increased incidence of coronary artery disease in sleep apnoea: a long-term follow-up. Eur Resp J 2006;28:596-602. http://dx.doi.org/10.1183/09031936.06.00107805

Haentjens P, Van Meerhaeghe A, Moscariello A, De Weerdt S, Poppe K, Dupont A, et al. The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome: evidence from a meta-analysis of placebo-controlled randomized trials. Arch Intern Med 2007;167:757-64. http://dx.doi.org/10.1001/archinte.167.8.757

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2014-03-31

Como Citar

Campostrini, D. D. A., Prado, L. B. F. do, & Prado, G. F. do. (2014). Síndrome da Apneia Obstrutiva do Sono e Doenças Cardiovasculares. Revista Neurociências, 22(1), 102–112. https://doi.org/10.34024/rnc.2014.v22.8127

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Seção

Revisão de Literatura
Recebido: 2019-02-16
Publicado: 2014-03-31

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