Pode ocorrer com a privação de sono de curto prazo.[225]Vgontzas AN, Bixler EO, Chrousos GP. Metabolic disturbances in obesity versus sleep apnoea: the importance of visceral obesity and insulin resistance. J Intern Med. 2003 Jul;254(1):32-44.
https://onlinelibrary.wiley.com/doi/full/10.1046/j.1365-2796.2003.01177.x?sid=nlm%3Apubmed
http://www.ncbi.nlm.nih.gov/pubmed/12823641?tool=bestpractice.com
O risco de hipertensão, disritmia, AVC, doença arterial coronariana e doença renal crônica é elevado com apneia obstrutiva do sono (AOS).[12]Chang JL, Goldberg AN, Alt JA, et al. International consensus statement on obstructive sleep apnea. Int Forum Allergy Rhinol. 2023 Jul;13(7):1061-482.
https://onlinelibrary.wiley.com/doi/10.1002/alr.23079
http://www.ncbi.nlm.nih.gov/pubmed/36068685?tool=bestpractice.com
[25]Mehra R, Chung MK, Olshansky B, et al. Sleep-disordered breathing and cardiac arrhythmias in adults: mechanistic insights and clinical implications: a scientific statement from the American Heart Association. Circulation. 2022 Aug 30;146(9):e119-e136.
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001082
http://www.ncbi.nlm.nih.gov/pubmed/35912643?tool=bestpractice.com
[161]Peker Y, Hedner J, Norum J, et al. Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: a 7-year follow-up. Am J Respir Crit Care Med. 2002 Jul 15;166(2):159-65.
http://www.atsjournals.org/doi/full/10.1164/rccm.2105124#.UtPPGdJdURE
http://www.ncbi.nlm.nih.gov/pubmed/12119227?tool=bestpractice.com
[217]Marin JM, Carrizo SJ, Vicente E, et al. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005 Mar 19-25;365(9464):1046-53.
http://www.ncbi.nlm.nih.gov/pubmed/15781100?tool=bestpractice.com
[218]Molnar MZ, Mucsi I, Novak M, et al. Association of incident obstructive sleep apnoea with outcomes in a large cohort of US veterans. Thorax. 2015 Sep;70(9):888-95.
https://thorax.bmj.com/content/70/9/888.long
http://www.ncbi.nlm.nih.gov/pubmed/26038534?tool=bestpractice.com
[219]Bassetti CLA, Randerath W, Vignatelli L, et al. EAN/ERS/ESO/ESRS statement on the impact of sleep disorders on risk and outcome of stroke. Eur J Neurol. 2020 Jul;27(7):1117-36.
https://onlinelibrary.wiley.com/doi/10.1111/ene.14201
http://www.ncbi.nlm.nih.gov/pubmed/32314498?tool=bestpractice.com
[220]Gottesman RF, Lutsey PL, Benveniste H, et al. Impact of sleep disorders and disturbed sleep on brain health: a scientific statement from the American Heart Association. Stroke. 2024 Mar;55(3):e61-76.
https://www.ahajournals.org/doi/full/10.1161/STR.0000000000000453
http://www.ncbi.nlm.nih.gov/pubmed/38235581?tool=bestpractice.com
Um possível mecanismo comum é o estresse oxidativo secundário à hipóxia, à disfunção endotelial e à ativação autonômica simpática.
longo prazo
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Possivelmente atribuídos à fragmentação do sono e/ou estresse oxidativo.[221]Banno K, Kryger MH. Sleep apnea: clinical investigations in humans. Sleep Med. 2007 Jun;8(4):400-26.
http://www.ncbi.nlm.nih.gov/pubmed/17478121?tool=bestpractice.com
A sonolência e a diminuição da atenção são comuns com a AOS. A taxa de risco de acidentes com veículos automotores é maior que o normal. O paciente pode relatar uma história de acidentes com veículos automotores devidos a sonolência ao dirigir.[26]Bonsignore MR, Randerath W, Schiza S, et al. European Respiratory Society statement on sleep apnoea, sleepiness and driving risk. Eur Respir J. 2021 Feb;57(2):2001272.
https://erj.ersjournals.com/content/57/2/2001272.long
http://www.ncbi.nlm.nih.gov/pubmed/33008939?tool=bestpractice.com
[27]Das AM, Chang JL, Berneking M, et al. Enhancing public health and safety by diagnosing and treating obstructive sleep apnea in the transportation industry: an American Academy of Sleep Medicine position statement. J Clin Sleep Med. 2022 Oct 1;18(10):2467-70.
https://jcsm.aasm.org/doi/10.5664/jcsm.9670
http://www.ncbi.nlm.nih.gov/pubmed/34534065?tool=bestpractice.com
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Comprometimento da excitação, vigilância, atenção executiva e inteligência.[222]Naegele B, Thouvard V, Pepin JL, et al. Deficits of cognitive executive functions in patients with sleep apnea syndrome. Sleep. 1995 Jan;18(1):43-52.
http://www.ncbi.nlm.nih.gov/pubmed/7761742?tool=bestpractice.com
Possivelmente atribuídos à fragmentação do sono e/ou estresse oxidativo.
A AOS também tem sido associada a maiores riscos de demência por todas as causas, doença de Alzheimer e demência na doença de Parkinson.[220]Gottesman RF, Lutsey PL, Benveniste H, et al. Impact of sleep disorders and disturbed sleep on brain health: a scientific statement from the American Heart Association. Stroke. 2024 Mar;55(3):e61-76.
https://www.ahajournals.org/doi/full/10.1161/STR.0000000000000453
http://www.ncbi.nlm.nih.gov/pubmed/38235581?tool=bestpractice.com
[223]Guay-Gagnon M, Vat S, Forget MF, et al. Sleep apnea and the risk of dementia: a systematic review and meta-analysis. J Sleep Res. 2022 Oct;31(5):e13589.
http://www.ncbi.nlm.nih.gov/pubmed/35366021?tool=bestpractice.com
Estudos de neuroimagem têm identificado lesões no sistema nervoso central em pacientes com AOS.[224]Zimmerman ME, Aloia MS. A review of neuroimaging in obstructive sleep apnea. J Clin Sleep Med. 2006 Oct 15;2(4):461-71.
http://www.ncbi.nlm.nih.gov/pubmed/17557478?tool=bestpractice.com
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Principalmente devido a doença cardiovascular.[164]Marti S, Sampol G, Munoz X, et al. Mortality in severe sleep apnoea/hypopnoea syndrome patients: impact of treatment. Eur Respir J. 2002 Dec;20(6):1511-8.
http://erj.ersjournals.com/cgi/content/full/20/6/1511
http://www.ncbi.nlm.nih.gov/pubmed/12503712?tool=bestpractice.com
[226]Marshall NS, Wong KK, Liu PY, et al. Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study. Sleep. 2008 Aug;31(8):1079-85.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2542953/?tool=pubmed
http://www.ncbi.nlm.nih.gov/pubmed/18714779?tool=bestpractice.com
[227]Young T, Finn L, Peppard PE, et al. Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin Sleep Cohort. Sleep. 2008 Aug;31(8):1071-8.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2542952/?tool=pubmed
http://www.ncbi.nlm.nih.gov/pubmed/18714778?tool=bestpractice.com
[228]Campos-Rodriguez F, Pena-Grinan N, Reyes-Nunez N, et al. Mortality in obstructive sleep apnea-hypopnea patients treated with positive airway pressure. Chest. 2005 Aug;128(2):624-33.
http://www.ncbi.nlm.nih.gov/pubmed/16100147?tool=bestpractice.com
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