臨牀透析 Vol.18 No.2(7)


特集名 透析療法とsleep apnea syndrome (SAS)
題名 肥満とSAS
発刊年月 2002年 02月
著者 赤柴 恒人 日本大学医学部内科学講座内科一
【 要旨 】 閉塞型睡眠時無呼吸症候群(OSAS)は,睡眠中に繰り返し出現する上気道閉塞が基本的な病態生理である.この睡眠中の上気道閉塞には,上気道の形態的,機能的異常が関与するが,肥満は前者に大きな影響を及ぼす.多くのOSAS患者は中年の肥満したいびきの常習者である.肥満者の上気道は,脂肪や軟部組織の発達により,覚醒時においてすでに狭小化しているため,睡眠中の上気道筋の弛緩により容易に閉塞しOSASが起こりやすい.したがって,肥満はOSASのもっとも重要なリスクファクターである.しかし,欧米に比し,わが国の肥満の程度は軽いにもかかわらずSASの頻度に大きな差がみられない.この事実は,わが国のSASの発症には,肥満以外の因子が大きく関与している可能性を示唆する.
Theme Sleep Apnea Syndrome in Maintenance Hemodialysis Patients
Title Obesity and sleep apnea syndrome
Author Tsuneto Akashiba First Department of Internal Medicine, Nihon University School of Medicine
[ Summary ] Obstructive sleep apnea syndrome (OSAS) is characterized by repeated obstruction of the upper airway during sleep. Upper airway obstruction during sleep occurs due to anatomical or functional abnormalities. Obesity is associated with the upper airway anatomy. Most patients with OSAS are obese and habitual snorers. As they have abundant lipid deposition and soft tissue in the upper airway, their upper airway is narrow while awake and is obstructed easily during sleep. Therefore, it seems that obesity is the most important risk factor in the development of OSAS. However, the prevalence of SAS is similar in Japan, the US and European countries, despite the fact that US and European people tend to be more obese than Japanese. This fact suggests that other factors play important roles in development of OSAS in Japan.
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