Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya3223510.17116/terarkh2017891107-111Editorial articleПередовая статьяReview ArticleThe problem of obstructive sleep apnea syndrome in asthmatic patientsПроблема синдрома обструктивного апноэ во сне у пациентов с бронхиальной астмойSheludkoE GШелудькоЕ ГNaumovD EНаумовД ЕPerelmanYu MПерельманЮ МKolosovV PКолосовВ ПДальневосточный научный центр физиологии и патологии дыхания15012017891VOL 89, NO1 ()ТОМ 89, №1 (2017)10711110042020Copyright ©; 2017, Consilium MedicumCopyright ©; 2017, ООО "Консилиум Медикум"2017Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/32235

Asthma and obstructive sleep apnea syndrome (OSAS) are one of the most common chronic respiratory diseases. These have common risk factors that include obesity, gastroesophageal reflux disease (GERD) and impaired nasal breathing (allergic rhinitis, sinusitis). At the same time, experimental evidence demonstrates common pathophysiological mechanisms of these diseases, such as involvement in the process of the respiratory tract, a systemic inflammatory response, and implementation of neuromechanical reflexes. Thus, there is an obvious synergism between these conditions, which affects symptoms, response to therapy, and prognosis. The available data allow discussion on whether there is a need to identify and treat OSAS in asthmatic patients. By keeping in mind the high incidence of OSAS in patients with severe asthma, it may be suggested that treatment for OSAS can reduce the number of exacerbations, improve the quality of life, and decline the number of obstinate asthma cases. It is very important for general practitioners to assess risk factors, such as body weight, nasal stuffiness, and GERD, and to utilize screening tools for more efficient use of healthcare resources. Considering the known positive effects of CPAP therapy in short-term studies, future investigations should focus on the impact of CPAP therapy on asthma symptoms in the long-term, as well as on the effects of asthma drugs on the course of OSAS.

Аннотация Бронхиальная астма (БА) и синдром обструктивного апноэ во сне (СОАС) — одни из самых распространенных хронических заболеваний дыхательной системы. Они имеют общие факторы риска, к которым относятся ожирение, гастроэзофагеальная рефлюксная болезнь (ГЭРБ) и нарушение носового дыхания (аллергические риниты, синуситы). При этом экспериментальные данные показывают общие патофизиологические звенья этих заболеваний: вовлечение в процесс дыхательных путей, системный воспалительный ответ, а также реализация нейромеханических рефлексов. Таким образом, очевиден синергизм этих заболеваний, который влияет на симптомы у пациентов, ответ на терапию и прогноз. Имеющиеся данные позволяют обсуждать необходимость выявления и лечения СОАС у пациентов с БА. Учитывая высокую распространенность СОАС у пациентов с тяжелой БА, можно предположить, что лечение СОАС может снизить количество обострений, улучшить качество жизни и уменьшить число случаев трудно контролируемой БА. Для врачей практического здравоохранения очень важно оценивать факторы риска, такие как масса тела, заложенность носа, наличие ГЭРБ, а также применять инструменты скрининга для более эффективного использования ресурсов здравоохранения. Учитывая известные положительные эффекты от CPAP-терапии в непродолжительных исследованиях, будущие работы должны быть направлены на изучение воздействия CPAP-терапии на симптомы БА в долгосрочной перспективе, а также активнее исследовать влияние препаратов для лечения БА на течение СОАС.

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