Вплив порушень сну на формування та перебіг серцево-судинних захворювань. Огляд літератури
DOI:
https://doi.org/10.30978/UTJ2022-1-68Ключові слова:
інсомнія, порушення сну, гіпертонічна хвороба, цукровий діабетАнотація
В основі формування порушень сну, гіпертонічної хвороби (ГХ) та цукрового діабету (ЦД) 2 типу лежать декілька спільних механізмів патогенезу. Насамперед слід ураховувати можливу активацію симпатоадреналової системи, яка спричиняє патогенез гіпертонії і завжди супроводжує відсутність якісного сна. Встановлено, що рівень маркерів системного запалення підвищується як при хронічному порушенні сну, так і при ГХ та ЦД 2 типу. Підвищення вмісту альдостерону також характерне для порушень сну, ГХ і ЦД. У декількох дослідженнях продемонстровано роль ендотеліальної дисфункції в розвитку хронічних порушень сну. Недотримання харчової поведінки, а саме споживання висококалорійної їжі перед сном, є чинником ризику розвитку як ЦД, так і порушень сну. В нормі існують циркадні ритми регуляції артеріального тиску, продукції та секреції інсуліну, які можуть спостерігатися при циркадних порушеннях сну. Ще одним чинником, що спричиняє формування порушень сну у пацієнтів з ГХ та ЦД, є зростання рівня тривожності та депресії, які також часто супроводжують обидва стани.
Не встановлено, які саме чинники спричиняють розвиток безсоння у хворих на ГХ і ЦД. Відсутні дані щодо частоти різних порушень сну у цієї групи хворих в українській популяції. Не досліджено ролі гормонів стресу у формуванні хронічних порушень сну. Найважливішим чинником, на думку практикуючого лікаря, є вплив препаратів для лікування ГХ і ЦД на якість сну. Не вивчено ролі немедикаментозної корекції (навчання пацієнтів основам гігієни сну) в лікуванні та профілактиці порушень сну.
Таким чином, безсоння може бути як чинником ризику ГХ та ЦД, так і часто супроводжувати їх, значною мірою впливаючи на якість життя хворих, ефективність лікування та прогноз у цієї групи пацієнтів.
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