臨牀透析 Vol.18 No.2(8)


特集名 透析療法とsleep apnea syndrome (SAS)
題名 内分泌・代謝異常とSAS
発刊年月 2002年 02月
著者 榊原 博樹 藤田保健衛生大学医学部呼吸器内科・アレルギー科
著者 内山 康裕 藤田保健衛生大学医学部呼吸器内科・アレルギー科
著者 姫野 一成 藤田保健衛生大学医学部呼吸器内科・アレルギー科
【 要旨 】 内分泌および代謝機能は，しばしば睡眠－覚醒の影響を受ける．閉塞型睡眠時無呼吸はいろいろなタイプの睡眠障害(深睡眠の減少，頻回の覚醒，REM睡眠周期の異常)の原因となり，それが神経内分泌や代謝機能の異常を導く可能性がある．TNFαは睡眠物質の一つであり，閉塞型睡眠時無呼吸症候群患者の血漿TNFαレベルは睡眠障害のために上昇している可能性がある．TNFαレベルの上昇は，閉塞型睡眠時無呼吸症候群患者にみられるインスリン抵抗性発症のキーファクターであるかもしれない．一方，一部の内分泌疾患(甲状腺機能低下症，末端肥大症，クッシング症候群など)は睡眠時無呼吸を引き起こす．
Theme Sleep Apnea Syndrome in Maintenance Hemodialysis Patients
Title Endocrine disorders and sleep apnea syndrome
Author Hiroki Sakakibara Division of Respiratory Medicine and Clinical Allergy, Department of Internal Medicine, Fujita Health University School of Medicine
Author Yasuhiro Uchiyama Division of Respiratory Medicine and Clinical Allergy, Department of Internal Medicine, Fujita Health University School of Medicine
Author Kazunari Himeno Division of Respiratory Medicine and Clinical Allergy, Department of Internal Medicine, Fujita Health University School of Medicine
[ Summary ] Endocrine and metabolic physiology is often influenced by behavioral states of sleep and wakefulness. Obstructive sleep apnea cause various types of sleep disturbance, decreased deep sleep, frequent arousals, and abnormal REM-sleep cycle, which may lead to abberations in neuroendocrine and metabolic functions. TNF alpha is a somnogenic factor, and patients with obstructive sleep apnea syndrome may have an elevated plasma TNF alpha level due to chronic sleep disturbance. The elevated TNF alpha level may be a key factor for the development of insulin resistance in patients with obstructive sleep apnea syndrome. Conversely, a certain endocrine disorders, such as hypothyroidism, acromegaly and Cushing's syndrome cause sleep apnea.
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