코 고는 여성, 남성보다 더 위험하다 Snoring Poses Greater Cardiac Risk to Women
Snoring Poses Greater Cardiac Risk to Women
CHICAGO, Nov. 29, 2018 /PRNewswire/ -- Obstructive sleep apnea (OSA) and snoring may lead to earlier impairment of cardiac function in women than in men, according to a new study presented today at the annual meeting of the Radiological Society of North America (RSNA). Moreover, the findings suggested that OSA may be vastly underdiagnosed among snorers.
HealthCentral
코 고는 여성, 남성보다 더 위험하다 코를 고는 여성은 심장 기능이 손상될 위험이 남성보다 더 크다는 연구 결과가 나왔다. 심장 기능 손상 위험 더 높아 제대로 진단받지 못하는 경우 많아 북미 방사선 학회 연례 회의에서 발표된 연구에 따르면 코골이 환자 가운데 폐쇄성 수면 무호흡 증상을 보이는 경우가 많지만, 제대로 진단받지 못하는 경우가 많다. 수면 장애의 일종인 폐쇄성 무호흡은 심장의 좌심실에 문제를 일으킬 위험이 있으며, 드물게는 우심실의 기능에 장애를 초래한다. 폐쇄성 수면 무호흡은 기도 주변 근육이 이완하면서 공기의 흡입과 배출을 막으면서 발생한다. 자는 동안 순간적으로 호흡이 멎거나, 입이 마르고, 자고 일어났을 때 두통을 느끼기도 한다. 특히 요란하게 코를 고는 게 대표적인 증상이다.
연구진은 영국의 보건 데이터인 UK 바이오 뱅크에서 심장 MRI를 받은 적 있는 환자 4800여 명의 자료를 추출했다. 그중 118명은 폐쇄성 수면 무호흡 진단을 받았고, 1886명은 코골이 증상을 호소했으며, 나머지는 무호흡이나 코골이 증상이 없는 환자들이었다. 연구진에 따르면 폐쇄성 수면 무호흡이나 코골이 증상을 보이는 환자들의 좌심실은 증상이 없는 사람에 비해 컸다. 부족한 산소를 벌충하려고 좌심실이 더 강하게 움직인 탓이다. 연구진은 특히 여성 코골이 환자의 좌심실 부피에 주목했다. 정상인과의 차이가 남성보다 더 컸기 때문이다.
이번 연구를 주도한 독일 뮌헨 대학교의 아드리안 쿠르타 박사는 “여러 지표를 분석한 결과, 코골이와 수면 무호흡증은 여성의 심장 건강에 더 큰 위험을 줄 수 있다”고 설명했다. 그는 “연구 대상자 중 폐쇄성 수면 무호흡 진단을 받은 환자는 극히 적었다”면서 “심장 기능에 문제가 생긴 코골이 환자까지 고려한다면 폐쇄성 수면 무호흡증은 제대로 진단되지 못하는 형편”이라고 지적했다. 쿠르타 박사는 “코를 심하게 고는 사람은 폐쇄성 수면 무호흡증인지 확인하여 적절한 치료를 받아야 한다”면서 “파트너에게 자는 동안 숨을 제대로 쉬는지 관찰해달라고 요청하거나, 수면 클리닉에 가서 검사를 받는 게 좋다”고 강조했다. 폐쇄성 수면 무호흡증은 체중을 감량하거나, 상기도의 공기 소통을 원활하게 해주는 장치를 이용해 치료할 수 있으며, 심한 경우 수술이 필요하다. 이용재 기자 youngchaeyi@kormedi.com 코메디닷컴 |
edited by kcontents
A common but dangerous sleep disorder, OSA causes an increased risk for left ventricular and, more rarely, right ventricular dysfunction in the heart.
OSA is the most common type of sleep apnea. It occurs when the throat muscles intermittently relax and block the airway while a person sleeps. While there are several symptoms of OSA—such as gasping for air during sleep, waking with a dry mouth, morning headache and irritability—loud snoring is a common sign. Complications of OSA may include daytime fatigue and sleepiness, complications with medications and surgery, and cardiovascular problems.
Researchers investigated cardiac function in relation to diagnosed OSA and self-reported snoring from data available through UK Biobank. A national and international health resource, UK Biobank is open to researchers and follows the health and well-being of 500,000 volunteer participants. Its aim is to improve the prevention, diagnosis and treatment of a wide range of serious and life-threatening illnesses.
For this study, data from 4,877 UK Biobank participants who had received a cardiac MRI were analyzed. The patients were allocated to three study groups: those with OSA (118 patients), those with self-reported snoring (1,886 patients), and those who are unaffected—without OSA or snoring (2,477 patients). There were 396 individuals who did not meet research criteria.
"Our analysis showed that in both genders of the OSA and snoring groups there was an increase in left ventricular mass, meaning that the walls of the heart's main pumping chamber are enlarged, making the heart work harder," said lead author Adrian Curta, M.D., radiology resident at Munich University Hospital in Munich, Germany. "We also found that men showed an increase in the ejection fraction of both ventricles."
Ejection fraction is the percentage of the heart chamber's total volume that is pumped out with each heartbeat.
When the researchers compared the snoring group to the unaffected group, they found a more significant difference in the left ventricular mass in women than in men. The cardiac changes in the self-reported snorers point to earlier impairment and might be an indication of undiagnosed OSA.
Illustration of obstruction of ventilation. Credit: Habib M'henni / public domain/Medical Xpress
edited by kcontents
"We found that the cardiac parameters in women appear to be more easily affected by the disease and that women who snore or have OSA might be at greater risk for cardiac involvement," Dr. Curta said. "We also found that the prevalence of diagnosed OSA in the study group was extremely low. Together with the alterations in cardiac function in the snoring group, it leads us to believe that OSA may be grossly underdiagnosed."
The findings suggest that the transition from snoring to OSA is an evolving process that is associated with left ventricular hypertrophy, an independent predictor for increased adverse events and in-hospital mortality in many procedures.
Dr. Curta stresses the importance for people who snore to get screened for OSA, and cautioned that those with OSA should be properly treated.
"I would encourage people who snore to ask their partner to observe them and look for phases during sleep when they stop breathing for a short while and then gasp for air," Dr. Curta said. "If unsure, they can spend the night at a sleep lab where breathing is constantly monitored during sleep and even slight alterations can be recorded."
Treatment is dependent on the cause of an individual's OSA, Dr. Curta noted. Weight loss, for example, can often improve OSA in overweight individuals. Apart from that, there are surgical techniques and special machines that keep the upper airways open at nighttime by applying continuous positive airway pressure (CPAP).
Since this was a population study, the researchers hope to conduct further studies to gain more insight into the gender differences associated with snoring and OSA.
Co-authors are Holger Hetterich, M.D., Regina Schinner, Aaron M. Lee, Wieland H. Sommer, M.D., Harald Kramer, M.D., Nay Aung, Mihir Sanghvi, Kenneth Fung, Elena Lukaschuk, Jackie Cooper, Jose M. Paiva, Valentina Carapella, Stefan Neubauer, Stefan Piechnik and Steffen E. Petersen.
Note: Copies of RSNA 2018 news releases and electronic images will be available online at RSNA.org/press18 beginning Monday, Nov. 26.
RSNA is an association of over 54,000 radiologists, radiation oncologists, medical physicists and related scientists, promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)
Editor's note: The data in these releases may differ from those in the published abstract and those actually presented at the meeting, as researchers continue to update their data right up until the meeting. To ensure you are using the most up-to-date information, please contact us.
For patient-friendly information on cardiac MRI, visit RadiologyInfo.org.
SOURCE Radiological Society of North America (RSNA)
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