Consilium MedicumConsilium MedicumConsilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum9522810.26442/20751753.2019.9.190508ArticlesСтатьиReview ArticlePsyho-neurological aspects of obstructive sleep apnea syndromeПсихоневрологические аспекты синдрома обструктивного апноэ снаLavrenikovaKarina I.ЛАВРЕНИКОВАКАРИНА ИВАНОВНА

канд. мед. наук, врач-кардиолог, ГБУЗ КО «ГКБ №2 Сосновая роща»

karina1606@rambler.ruElfimovaEvgeniia M.ЕЛФИМОВАЕВГЕНИЯ МИХАЙЛОВНА

канд. мед. наук, науч. сотр. лаб. апноэ сна отд. гипертонии ИКК им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

MikhailovaOksana O.МИХАЙЛОВАОКСАНА ОЛЕГОВНА

канд. мед. наук, мл. науч. сотр. лаб. апноэ сна отд. гипертонии ИКК им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

KhachatryanNarine T.ХАЧАТРЯННАРИНЕ ТИГРАНОВНА

ординатор отд. гипертонии ИКК им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

FedorovaVera I.ФЕДОРОВАВЕРА ИВАНОВНА

д-р мед. наук, врач-невролог ИКК им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

LitvinAleksandr Yu.ЛИТВИНАЛЕКСАНДР ЮРЬЕВИЧ

д-р мед. наук, рук. лаб. апноэ сна, гл. науч. сотр. отд. гипертонии, проф. отд. высшего и дополнительного профессионального образования ФГБУ «НМИЦ кардиологии», проф. каф. поликлинической терапии лечебного фак-та ФГБОУ ВО «РНИМУ им. Н.И. Пирогова».

OhazovaIrina E.ЧАЗОВАИРИНА ЕВГЕНЬЕВНА

акад. РАН, д-р мед. наук, проф., дир. ИКК им. А.Л. Мясникова ФГБУ «НМИЦ Кардиологии»

City Clinical Hospital №2 “Sosnovaia roshcha”ГБУЗ КО «Городская клиническая больница №2 “Оосновая роща”»National Medical Research Center for CardiologyФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава РоссииNational Medical Research Center for Cardiology 3Pirogov Russian National Research Medical UniversityФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава РоссииФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииNational Medical Research Center for CardiologyФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России15092019219VOL 21, NO9 (2019)ТОМ 21, №9 (2019)697328122021Copyright ©; 2019, Consilium MedicumCopyright ©; 2019, ООО "Консилиум Медикум"2019Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://consilium.orscience.ru/2075-1753/article/view/95228

Obstructive sleep apnoea syndrome (OSAS) is one of the most frequent forms of sleep-disordered breathing. Increase of risk of development and progressing of most cardiovascular disorders is typical for this condition. In clinical presentation manifestations from nervous system such as severe daytime sleepiness, cognitive decline, anxiety and depressive disorders often predominate. OSAS occurs in most widespread neurologic disorders, at present a lot of studies emerge describing its interconnections. On the one hand, sleep-related breathing disorders are often a risk factor for neurological disorders and may complicate their flow; on the other hand, they are often the result of nerve diseases. Intermittent hypoxia that develops against the background of breathing disorders plays a key role in the pathophysiology of cardiovascular and neurological complications. Article presents existing studies that describe the relationship between obstructive sleep apnea syndrome and neurological diseases such as cerebral apoplexy, Alzheimer's disease, Parkinson's disease, epilepsy, neurodegenerative and neuromuscular diseases. At the present time, CPAP therapy remains the gold standard for the treatment of obstructive sleep apnea syndrome throughout the world. When neurological pathology is combined with the syndrome of obstructive sleep apnea, the addition of CPAP therapy to the main drug treatment often has a statistically significant positive effect on the course and prognosis of neurological diseases.

Синдром обструктивного апноэ сна (СОАС) - одна из самых распространенных форм нарушения дыхания во сне. Для него характерно увеличение риска развития и прогрессирования большинства сердечно-сосудистых заболеваний, а в клинической картине нередко преобладают проявления со стороны нервной системы: выраженная дневная сонливость, когнитивные, тревожные и депрессивные расстройства. СОАС встречается при самых распространенных неврологических заболеваниях, и за последнее время появилось множество исследований, описывающих их взаимосвязь. С одной стороны, нарушения дыхания во сне часто являются фактором риска возникновения неврологической патологии и способны осложнять ее течение, с другой - они часто являются следствием нервных болезней. Интермиттирующая гипоксия, развивающаяся на фоне нарушений дыхания, является ключевым звеном патогенеза формирования сердечно-сосудистых и неврологических осложнений. В представленном обзоре приведены исследования, описывающие взаимосвязь СОАС с такими неврологическими заболеваниями, как церебральный инсульт, болезнь Альцгеймера, болезнь Паркинсона, эпилепсия, нейродегенеративные и нейромышечные заболеваниями. На сегодняшний день «золотым стандартом» лечения СОАС во всем мире остается СИПАП-терапия (транслитерация с англ. - OPAP: Continuous Positive Airway Pressure) - лечение путем создания постоянного положительного давления в верхних дыхательных путях. При сочетании неврологической патологии с СОАС добавление СИПАП-терапии к основному медикаментозному лечению часто оказывает статистически значимый положительный эффект на течение и прогноз неврологического заболевания.

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