cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2021-36-1-58-65cardiotomsk-1132Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESВзаимосвязь синдрома обструктивного апноэ сна и факторов сердечно-сосудистого рискаRelationships between obstructive sleep apnea syndrome and cardiovascular risk factorshttps://orcid.org/0000-0003-3554-0659ЕвлампиеваЛ. Г.EvlampievaL. G.

 канд. мед. наук, младший научный сотрудник, лаборатория инструментальной диагностики научного отдела инструментальных методов исследования 

 625026, Российская Федерация, Тюмень, ул. Мельникайте, 111 

 Cand. Sci. (Med.), Junior Research Scientist, Laboratory of Instrumental Diagnostics, Scientific Division of Instrumental Research Methods

 111, Melnikaite str., Tyumen, 625026, Russian Federation 

evlampieva.l.g@gmail.comhttps://orcid.org/0000-0003-1436-8853ЯрославскаяЕ. И.YaroslavskayaE. I.

 д-р мед. наук, и.о. заведующего научным отделом инструментальных методов исследования

 625026, Российская Федерация, Тюмень, ул. Мельникайте, 111 

 Dr. Sci. (Med.), Acting Head of the Laboratory of Instrumental Research Methods 

 111, Melnikaite str., Tyumen, 625026, Russian Federation 

yaroslavskayae@gmail.comhttps://orcid.org/0000-0002-6297-7859ХарацВ. Е.KharatsV. E.

 канд. мед. наук, старший научный сотрудник, лаборатория инструментальной диагностики научного отделаинструментальных методов исследования

 625026, Российская Федерация, Тюмень, ул. Мельникайте, 111 

 Cand. Sci. (Med.), Senior Research Scientist, Laboratory of Instrumental Diagnostics, Scientific Division of Instrumental Research Methods 

 111, Melnikaite str., Tyumen, 625026, Russian Federation 

Тюменский кардиологический научный центр, Томский национальный исследовательский медицинский центр Российской академии наукРоссияTyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences Russian Federation2021020420213615865Copyright © Евлампиева Л.Г., Ярославская Е.И., Харац В.Е., 20212021Евлампиева Л.Г., Ярославская Е.И., Харац В.Е.Evlampieva L.G., Yaroslavskaya E.I., Kharats V.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sibjcem.ru/jour/article/view/1132

 В обзорной статье проанализированы данные отечественных и зарубежных источников, отражающие текущее состояние такой распространенной проблемы, как синдром обструктивного апноэ сна (СОАС). Описаны основные механизмы развития и возможная связь сердечно-сосудистых заболеваний (ССЗ) и основных факторов риска у пациентов с этим симптомокомплексом расстройства дыхания во сне. Освещено современное состояние проблемы применения СИПАП-терапии (от англ. СРАР – Continuous Positive Airway Pressure – создание  постоянного положительного давления в дыхательных  путях), обосновывается необходимость изучения ее влияния  на факторы сердечнососудистого риска в различных  субгруппах коморбидных пациентов.  

The review analyzes data from domestic and foreign sources focusing on the current state of a common problem of obstructive sleep apnea syndrome. The article describes the main mechanisms of development and the possible relationships between the cardiovascular diseases, main risk factors in patients, and the sleep-related breathing disorder symptom-complex. The article provides the status update on the problem of continuous positive  airway pressure (CPAP) therapy consisting in creating positive airway pressure ventilation and provides rationale for studying its effects on cardiovascular risk factors in various subgroups of comorbid patients.

синдром обструктивного апноэ снасердечно-сосудистый рискСИПАП-терапияobstructive sleep apneacardiovascular riskCPAP therapyисследование выполнено за счет средств федерального бюджета Тюменского кардиологического научного центра, Томский национальный исследовательский медицинский центр Российской академии наук.the study was conducted at the cost of the federal budget of Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of SciencesReferencesBenjafield A.V., Ayas N.T., Eastwood P.R., Heinzer R., Ip M.S.M., Morrell M.J. et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: A literature-based analysis. Lancet Respir. Med. 2019;7(8):687–698. DOI: 10.1016/S2213-2600(19)30198-5.Benjafield A.V., Ayas N.T., Eastwood P.R., Heinzer R., Ip M.S.M., Morrell M.J. et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: A literature-based analysis. Lancet Respir. Med. 2019;7(8):687–698. DOI: 10.1016/S2213-2600(19)30198-5.Байрамбеков Э.Ш., Певзнер А.В., Литвин А.Ю., Елфимова Е.М. Возможности диагностики и частота выявления синдрома обструктивного апноэ во время сна больных с различными формами фибрилляции предсердий. Кардиологический вестник. 2016; 11(2):34–41.Bairambekov E.Sh., Pevzner A.V., Litvin A.Yu., Elfimova E.M. Possibilities of diagnostics and the detection rate of obstructive sleep apnea in patients with various forms of atrial fibrillation. Russian Cardioligy Bulletine. 2016; 2(11):34–41 (In Russ.).Heinzer R., Vat S., Marques-Vidal P., Marti-Soler H., Andries D., Tobback N. et al. Prevalence of sleep-disordered breathing in the general population: The HypnoLaus study. Lancet Respir. Med. 2015;3(4):310–318. DOI: 10.1016/S2213-2600(15)00043-0.Heinzer R., Vat S., Marques-Vidal P., Marti-Soler H., Andries D., Tobback N. et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir. Med. 2015;3(4):310–318. DOI: 10.1016/S2213-2600(15)00043-0.Кузнецов Д.И. Cахарный диабет и синдром обструктивного апноэ во сне. Consilium Medicum. 2013;15(4):23–28.Kuznetsov D.I. Diabetes mellitus and obstructive sleep apnea syndrome. Consilium Medicum. 2013;15(4):23–28 (In Russ.).Медведева Е.А., Коростовцева Л.С., Сазонова Ю.В., Бочкарёв М.В., Свиряев Ю.В., Конради А.О. Синдром обструктивного апноэ во сне при хронической сердечной недостаточности: взгляд кардиолога. Российский кардиологический журнал. 2018;(1):78–82. DOI: 10.15829/1560-4071-2018-1-78-82.Medvedeva Е.А., Korostovtseva L.S., Sazonova Yu.V., Bochkarev М.V., Sviryaev Yu.V., Konradi А.О. Obstructive sleep apnea syndrome in congestive heart failure: Cardiologist perspective. Russian Journal Cardiology. 2018;(1):78–82 (In Russ.). DOI: 10.15829/1560-4071-2018-1-78-82.Young T., Peppard P.E., Gottlieb D.J. Epidemiology of obstructive sleep apnea: A population health perspective. Am. J. Respir. Crit. Care Med. 2002;165(9):1217–1239. DOI: 10.1164/rccm.2109080.Young T., Peppard P.E., Gottlieb D.J. Epidemiology of obstructive sleep apnea: A population health perspective. Am. J. Respir. Crit. Care Med. 2002;165(9):1217–1239. DOI: 10.1164/rccm.2109080.Costa L.E., Uchôa C.H., Harmon R.R., Bortolotto L.A., Lorenzi-Filho G., Drager L.F. Potential underdiagnosis of obstructive sleep apnoea in the cardiology outpatient setting. Heart. 2015;101(16):1288–1292. DOI: 10.1136/heartjnl-2014-307276.Costa L.E., Uchôa C.H., Harmon R.R., Bortolotto L.A., Lorenzi-Filho G., Drager L.F. Potential underdiagnosis of obstructive sleep apnoea in the cardiology outpatient setting. Heart. 2015;101(16):1288–1292. DOI: 10.1136/heartjnl-2014-307276.Kapur V.K., Auckley D.H., Chowdhuri S., Kuhlmann D.C., Mehra R., Ramar K. et al. Clinical practice guideline. J. Clin. Sleep Med. 2017;13(3):479–504. DOI: 10.5664/jcsm.6506.Kapur V.K., Auckley D.H., Chowdhuri S., Kuhlmann D.C., Mehra R., Ramar K. et al. Clinical practice guideline. J. Clin. Sleep Med. 2017;13(3):479–504. DOI: 10.5664/jcsm.6506.Romero-Corral A., Caples S.M., Lopez-Jimenez F., Somers V.K. Interactions between obesity and obstructive sleep apnea: Implications for treatment. Chest. 2010;137(3):711–719. DOI: 10.1378/chest.09-0360.Romero-Corral A., Caples S.M., Lopez-Jimenez F., Somers V.K. Interactions between obesity and obstructive sleep apnea: Implications for treatment. Chest. 2010;137(3):711–719. DOI: 10.1378/chest.09-0360.Wetter D.W., Young T.B., Bidwell T.R., Badr M.S., Palta M. Smoking as a risk factor for sleep-disordered breathing. Arch. Intern. Med. 1994;154(19):2219–2224. DOI: 10.1001/archinte.1994.00420190121014.Wetter D.W., Young T.B., Bidwell T.R., Badr M.S., Palta M. Smoking as a risk factor for sleep- disordered breathing. Arch. Intern. Med. 1994;154(19):2219–2224. DOI: 10.1001/archinte.1994.00420190121014.Aronsohn R.S., Whitmore H., van Cauter E., Tasali E. Impact of untreated obstructive sleep apnea on glucose control in type 2 diabetes. Am. J. Respir. Crit. Care Med. 2010;181(5):507–513. DOI: 10.1164/rccm.200909-1423OC.Aronsohn R.S., Whitmore H., van Cauter E., Tasali E. Impact of untreated obstructive sleep apnea on glucose control in type 2 diabetes. Am. J. Respir. Crit. Care Med. 2010;181(5):507–513. DOI: 10.1164/rccm.200909-1423OC.Lam D.C.L., Lui M.M.S., Lam J.C.M., Ong L.H.Y., Lam K.S.L., Ip M.S.M. Prevalence and recognition of obstructive sleep apnea in Chinese patients with type 2 diabetes mellitus. Chest. 2010;138(5):1101–1107. DOI: 10.1378/chest.10-0596.Lam D.C.L., Lui M.M.S., Lam J.C.M., Ong L.H.Y., Lam K.S.L., Ip M.S.M. Prevalence and recognition of obstructive sleep apnea in Chinese patients with type 2 diabetes mellitus. Chest. 2010;138(5):1101–1107. DOI: 10.1378/chest.10-0596.Chobanian A.V., Bakris G.L., Black H.R., Cushman W.C., Green L.A., Izzo J.L. Jr. et al.; National Heart, Lung, and Blood Institute, Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289(19):2560–2572. DOI: 10.1001/jama.289.19.2560.Chobanian A.V., Bakris G.L., Black H.R., Cushman W.C., Green L.A., Izzo J.L. Jr. et al.; National Heart, Lung, and Blood Institute, Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289(19):2560–2572. DOI: 10.1001/jama.289.19.2560.Мисникова И.В., Ковалева Ю.А., Губкина В.А. Значение нарушений сна при сахарном диабете. Русский медицинский журнал. 2016;(1):42–46.Misnikova I.V., Kovaleva Yu.A., Gubkina V.A. Importance of sleep disorders in diabetes. Russian Medical Journal. 2016;(1):42–46 (In Russ.).Cappuccio F., Miller M. Sleep and cardio-metabolic disease. Curr. Cardiol. Rep. 2017;19(11):110. DOI: 10.1007/s11886-017-0916-0.Cappuccio F., Miller M. Sleep and cardio-metabolic disease. Curr. Cardiol. Rep. 2017;19(11):110. DOI: 10.1007/s11886-017-0916-0.Дубинина Е.А., Коростовцева Л.С., Ротарь О.П., Кравченко С.О., Бояринова М.А., Орлов А.В. и др. Взаимосвязь риска нарушений дыхания во сне и сердечно-сосудистого риска. Кардиоваскулярная терапия и профилактика. 2016;15(6):46–52. DOI: 10.15829/1728-8800-2016-6-46-52.Dubinina E.A., Korostovtseva L.S., Rotar О.P., Kravchenko S.О., Boyarinova М.A., Orlov A.V. et al. Еhe relation of sleep respiration disorders and cardiovascular risk. Cardiovascular Therapy and Prevention. 2016;15(6):46–52 (In Russ.). DOI: 10.15829/1728-8800-2016-6-46-52.Drager L.F., Togeiro S.M., Polotsky V.Y., Lorenzi-Filho G. Obstructive sleep apnea: А cardiometabolic risk in obesity and the metabolic syndrome. J. Am. Coll. Cardiol. 2013;62(7):569–576. DOI: 10.1016/j.jacc.2013.05.045.Drager L.F., Togeiro S.M., Polotsky V.Y., Lorenzi-Filho G. Obstructive sleep apnea: А cardiometabolic risk in obesity and the metabolic syndrome. J. Am. Coll. Cardiol. 2013;62(7):569–576. DOI: 10.1016/j.jacc.2013.05.045.Arnaud C., Poulain L., Levy P., Dematteis M. Inflammation contributes to the atherogenic role of intermittent hypoxia in apolipoprotein-E knock out mice. Atherosclerosis. 2011;219(2):425–431. DOI: 10.1016/j.atherosclerosis.2011.07.122.Arnaud C., Poulain L., Levy P., Dematteis M. Inflammation contributes to the atherogenic role of intermittent hypoxia in apolipoprotein-E knock out mice. Atherosclerosis. 2011;219(2):425–431. DOI: 10.1016/j.atherosclerosis.2011.07.122.Bironneau V., Tamisier R., Trzepizur W., Andriantsitohaina R., Berger M., Goupil F. et al. Sleep apnoea and endothelial dysfunction: An individual patient data meta-analysis. Sleep Med. Rev. 2020;52:101309. DOI: 10.1016/j.smrv.2020.101309.Bironneau V., Tamisier R., Trzepizur W., Andriantsitohaina R., Berger M., Goupil F. et al. Sleep apnoea and endothelial dysfunction: An individual patient data meta-analysis. Sleep Med. Rev. 2020;52:101309. DOI: 10.1016/j.smrv.2020.101309.Hoyos M., Melehan K.L., Liu P.Y., Grunstein R.R., Phillips C.L. Does obstructive sleep apnea cause endothelial dysfunction? A critical review of the literature. Sleep Med. Rev. 2015;20:15–26. DOI: 10.1016/j.smrv.2014.06.003.Hoyos M., Melehan K.L., Liu P.Y., Grunstein R.R., Phillips C.L. Does obstructive sleep apnea cause endothelial dysfunction? A critical review of the literature. Sleep Med. Rev. 2015;20:15–26. DOI: 10.1016/j.smrv.2014.06.003.Lesske J., Fletcher E.C., Bao G., Unger T. Hypertension caused by chronic intermittent hypoxia-influence of chemoreceptors and sympathetic nervous system. J. Hypertens. 1997;15(12):1593– 1603. DOI: 10.1097/00004872-199715120-00060.Lesske J., Fletcher E.C., Bao G., Unger T. Hypertension caused by chronic intermittent hypoxia-influence of chemoreceptors and sympathetic nervous system. J. Hypertens. 1997;15(12):1593–1603. DOI: 10.1097/00004872-199715120-00060.Li Q., Lin Y. Significance and research of biomarkers in obstructive sleep apnea hypopnea syndrome. Zhonghua Yi Xue Za Zhi. 2016;96(8):593–595. DOI: 10.3760/cma.j.issn.0376-2491.2016.08.001.Li Q., Lin Y. Significance and research of biomarkers in obstructive sleep apnea hypopnea syndrome. Zhonghua Yi Xue Za Zhi. 2016;96(8):593–595. DOI: 10.3760/cma.j.issn.0376-2491.2016.08.001.Евлампиева Л.Г., Ярославская Е.И., Аксенова К.В., Сергейчик О.И. Роль биомаркеров синдрома обструктивного апноэ сна в оценке сердечно-сосудистого риска. Сибирский журнал клинической и экспериментальной медицины. 2019;34(4):49–54. DOI: 10.29001/2073-8552-2019-34-4-49–54.Evlampieva L.G., Yaroslavskaya E.I., Aksenova K.V., Sergeichik O.I. The role of obstructive sleep apnea biomarkers in assessment of cardiovascular risk. The Siberian Journal of Clinical and Experimental Medicine. 2019;34(4):49–54 (In Russ.). DOI: 10.29001/2073-8552-2019-34-4-49–54.Imayama I., Prasad B. Role of leptin in obstructive sleep apnea. Ann. Am. Thorac. Soc. 2017;14(11):1607–1621. DOI: 10.1513/AnnalsATS.201702-181FR.Imayama I., Prasad B. Role of leptin in obstructive sleep apnea. Ann. Am. Thorac. Soc. 2017;14(11):1607–1621. DOI: 10.1513/AnnalsATS.201702-181FR.Ryan S., McNicholas W.T., Taylor C.T. A critical role for p38 map kinase in NF-kappaB signaling during intermittent hypoxia/reoxygenation. Biochem. Biophys. Res. Commun. 2007;355(3):728–733. DOI: 10.1016/j.bbrc.2007.02.015.Ryan S., McNicholas W.T., Taylor C.T. A critical role for p38 map kinase in NF-kappaB signaling during intermittent hypoxia/reoxygenation. Biochem. Biophys. Res. Commun. 2007;355(3):728–733. DOI: 10.1016/j.bbrc.2007.02.015.Htoo A.K., Greenberg H., Tongia S., Chen G., Henderson T., Wilson D. et al. Activation of nuclear factor kappaB in obstructive sleep apnea: A pathway leading to systemic inflammation. Sleep Breath. 2006;10(1):43–50. DOI: 10.1007/s11325-005-0046-6.Htoo A.K., Greenberg H., Tongia S., Chen G., Henderson T., Wilson D. et al. Activation of nuclear factor kappaB in obstructive sleep apnea: a pathway leading to systemic inflammation. Sleep Breath. 2006;10(1):43–50. DOI: 10.1007/s11325-005-0046-6.Yuan G., Khan S.A., Luo W., Nanduri J., Semenza G.L., Prabhakar N.R. Hypoxia-inducible factor 1 mediates increased expression of NADPH oxidase-2 in response to intermittent hypoxia. J. Cell Physiol. 2011;226(11):2925–2933. DOI: 10.1002/jcp.22640.Yuan G., Khan S.A., Luo W., Nanduri J., Semenza G.L., Prabhakar N.R. Hypoxia-inducible factor 1 mediates increased expression of NADPH oxidase-2 in response to intermittent hypoxia. J. Cell Physiol. 2011;226(11):2925–2933. DOI: 10.1002/jcp.22640.Garvey J.F., Taylor C.T., McNicholas W.T. Cardiovascular disease in obstructive sleep apnoea syndrome: The role of intermittent hypoxia and inflammation. Eur. Respir. J. 2009;33(5):1195–1205. DOI: 10.1183/09031936.00111208.Garvey J.F., Taylor C.T., McNicholas W.T. Cardiovascular disease in obstructive sleep apnoea syndrome: the role of intermittent hypoxia and inflammation. Eur. Respir. J. 2009;33(5):1195–1205. DOI: 10.1183/09031936.00111208.Lui M.M., Lam J.C., Mak H.K., Xu A., Ooi C., Lam D.C. et al. C-reactive protein is associated with obstructive sleep apnea independent of visceral obesity. Chest. 2009;135(4):950–956. DOI: 10.1378/chest.08-1798.Lui M.M., Lam J.C., Mak H.K., Xu A., Ooi C., Lam D.C. et al. C-reactive protein is associated with obstructive sleep apnea independent of visceral obesity. Chest. 2009;135(4):950–956. DOI: 10.1378/chest.08-1798.Pallayova M., Donic V., Gresova S., Peregrim I., Tomori Z. Do differences in sleep architecture exist between persons with type 2 diabetes and nondiabetic controls? J. Diabetes. Sci. Technol. 2010;4(2):344–352. DOI: 10.1177/193229681000400215.Pallayova M., Donic V., Gresova S., Peregrim I., Tomori Z. Do differences in sleep architecture exist between persons with type 2 diabetes and nondiabetic controls? J. Diabetes. Sci. Technol. 2010;4(2):344–352. DOI: 10.1177/193229681000400215.Altaf Q.A., Dodson P., Ali A., Raymond N.T., Wharton H., Fellows H. et al. Obstructive Sleep Apnea and Retinopathy in Patients with Type 2 Diabetes. A Longitudinal Study. Am. J. Respir. Crit. Care Med. 2017;196(7):892–900. DOI: 10.1164/rccm.201701-0175OC.Altaf Q.A., Dodson P., Ali A., Raymond N.T., Wharton H., Fellows H. et al. Obstructive Sleep Apnea and Retinopathy in Patients with Type 2 Diabetes. A Longitudinal Study. Am. J. Respir. Crit. Care Med. 2017;196(7):892–900. DOI: 10.1164/rccm.201701-0175OC.Floras J.S. Sleep apnea and cardiovascular disease: An enigmatic risk factor. Circ. Res. 2018;122(12):1741–1764. DOI: 10.1161/CIRCRESAHA.118.310783.Floras J.S. Sleep apnea and cardiovascular disease: An enigmatic risk factor. Circ. Res. 2018;122(12):1741–1764. DOI: 10.1161/CIRCRESAHA.118.310783.Neumann K., Arzt M., Heid I., Böger C., Stadler S. Sleep-disordered breathing is associated with metabolic syndrome in outpatients with diabetes mellitus type 2. J. Diabetes Res. 2019;2019: 8417575. DOI: 10.1155/2019/8417575.Neumann K., Arzt M., Heid I., Böger C., Stadler S. Sleep-disordered breathing is associated with metabolic syndrome in outpatients with diabetes mellitus type 2. J. Diabetes Res. 2019;2019: 8417575. DOI: 10.1155/2019/8417575.Broussard J.L., Ehrmann D.A., Van Cauter E., Tasali E., Brady M.J. Impaired insulin signaling in human adipocytes after experimental sleep restriction: A randomized, crossover study. Ann. Intern. Med. 2012;157(8):549–557. DOI: 10.7326/0003-4819-157-8-201210160-00005.Broussard J.L., Ehrmann D.A., Van Cauter E., Tasali E., Brady M.J. Impaired insulin signaling in human adipocytes after experimental sleep restriction: A randomized, crossover study. Ann. Intern. Med. 2012;157(8):549–557. DOI: 10.7326/0003-4819-157-8-201210160-00005.Khalyfa A., Wang Y., Zhang S.X., Qiao Z., Abdelkarim A., Gozal D. Sleep fragmentation in mice induces nicotinamide adenine dinucleotide phosphate oxidase 2-dependent mobilization, proliferation, and differentiation of adipocyte progenitors in visceral white adipose tissue. Sleep. 2014;37(5):999–1009. DOI: 10.5665/sleep.3678.Khalyfa A., Wang Y., Zhang S.X., Qiao Z., Abdelkarim A., Gozal D. Sleep fragmentation in mice induces nicotinamide adenine dinucleotide phosphate oxidase 2-dependent mobilization, proliferation, and differentiation of adipocyte progenitors in visceral white adipose tissue. Sleep. 2014;37(5):999–1009. DOI: 10.5665/sleep.3678.Мисникова И.В. Апноэ сна при эндокринной патологии. Альманах клинической медицины. 2016;44(4):493–500. DOI: 10.18786/2072-0505-2016-44-4-493-500.Misnikova I.V. Sleep apnea in endocrine disorders. Almanac of Clinical Medicine. 2016;44(4):493–500 (In Russ.). DOI: 10.18786/2072-0505-2016-44-4-493-500.Lee C.J., Park S. The role of carotid ultrasound for cardiovascular risk stratification beyond traditional risk factors. Yonsei Med. J. 2014;55(3):551–557. DOI: 10.3349/ymj.2014.55.3.551.Lee C.J., Park S. The role of carotid ultrasound for cardiovascular risk stratification beyond traditional risk factors. Yonsei Med. J. 2014;55(3):551–557. DOI: 10.3349/ymj.2014.55.3.551.Бузунов Р.В., Легейда И.В. Храп и синдром обструктивного апноэ сна: учебное пособие для врачей. М.: 2010:77.Buzunov R.V., Legeida I.V. Snoring and obstructive sleep apnea syndrome: A manual for doctors. Moscow; 2010:77 (In Russ.).Qaseem A., Holty J.E., Owens D.K., Dallas P., Starkey M., Shekelle P. Management of obstructive sleep apnea in adults: A clinical practice guideline from the American College of Physicians. Ann. Intern. Med. 2013;159(7):471–483. DOI: 10.7326/0003-4819-159-7-201310010-00704.Qaseem A., Holty J.E., Owens D.K., Dallas P., Starkey M., Shekelle P. Management of obstructive sleep apnea in adults: A clinical practice guideline from the American College of Physicians. Ann. Intern. Med. 2013;159(7):471–483. DOI: 10.7326/0003-4819-159-7-201310010-00704.Anandam A., Patil M., Akinnusi M., Jaoude P., El-Solh A.A. Cardiovascular mortality in obstructive sleep apnoea treated with continuous positive airway pressure or oral appliance: An observational study. Respirology. 2013;18(8):1184–1190. DOI: 10.1111/resp.12140.Anandam A., Patil M., Akinnusi M., Jaoude P., El-Solh A.A. Cardiovascular mortality in obstructive sleep apnoea treated with continuous positive airway pressure or oral appliance: An observational study. Respirology. 2013;18(8):1184–1190. DOI: 10.1111/resp.12140.Martínez-García M.A., Campos-Rodríguez F., Catalán-Serra P.,Martínez-García M.A., Campos-Rodríguez F., Catalán-Serra P., Soler-Cataluña J.J., Almeida-Gonzalez C., De la Cruz Morón I. et al. Cardiovascular mortality in obstructive sleep apnea in the elderly: Role of long-term continuous positive airway pressure treatment: A prospective observational study. Am. J. Respir. Crit. Care Med. 2012;186(9):909–916. DOI: 10.1164/rccm.201203-0448OC.Soler-Cataluña J.J., Almeida-Gonzalez C., De la Cruz Morón I. et al. Cardiovascular mortality in obstructive sleep apnea in the elderly: Role of long-term continuous positive airway pressure treatment: A prospective observational study. Am. J. Respir. Crit. Care Med. 2012;186(9):909–916. DOI: 10.1164/rccm.201203-0448OC.Campos-Rodriguez F., Martinez-Garcia M.A., de la Cruz-Moron I., Almeida-Gonzalez C., Catalan-Serra P., Montserrat J.M. Cardiovascular mortality in women with obstructive sleep apnea with or without continuous positive airway pressure treatment: A cohort study. Ann. Intern. Med. 2012;156(2):115–122. DOI: 10.7326/0003-4819-156-2-201201170-00006.Campos-Rodriguez F., Martinez-Garcia M.A., de la Cruz-Moron I., Almeida-Gonzalez C., Catalan-Serra P., Montserrat J.M. Cardiovascular mortality in women with obstructive sleep apnea with or without continuous positive airway pressure treatment: A cohort study. Ann. Intern. Med. 2012;156(2):115–122. DOI: 10.7326/0003-4819-156-2-201201170-00006.Wang X., Zhang Y., Dong Z., Fan J., Nie S., Wei Y. Effect of continuous positive airway pressure on long-term cardiovascular outcomes in patients with coronary artery disease and obstructive sleep apnea: A systematic review and meta-analysis. Respir. Res. 2018;19(1):61. DOI: 10.1186/s12931-018-0761-8.Wang X., Zhang Y., Dong Z., Fan J., Nie S., Wei Y. Effect of continuous positive airway pressure on long-term cardiovascular outcomes in patients with coronary artery disease and obstructive sleep apnea: A systematic review and meta-analysis. Respir. Res. 2018;19(1):61. DOI: 10.1186/s12931-018-0761-8.Baessler A., Nadeem R., Harvey M., Madbouly E., Younus A., Sajid H. et al. Treatment for sleep apnea by continuous positive airway pressure improves levels of inflammatory markers – a meta-analysis. J. Inflamm. (Lond.). 2013;10:13. DOI: 10.1186/1476-9255-10-13.Baessler A., Nadeem R., Harvey M., Madbouly E., Younus A., Sajid H. et al. Treatment for sleep apnea by continuous positive airway pressure improves levels of inflammatory markers – a meta-analysis. J. Inflamm. (Lond.). 2013;10:13. DOI: 10.1186/1476-9255-10-13.Kohler M., Stoewhas A.-C., Ayers L., Senn O., Bloch K.E., Russi E.W. et al. Effects of continuous positive airway plressure therapy with drawal in patients with obstructive sleep apnea: A randomized controlled trial. Am. J. Respir. Crit. Care Med. 2011;184(10):1192–1199. DOI: 10.1164/rccm.201106-0964OC.Kohler M., Stoewhas A.-C., Ayers L., Senn O., Bloch K.E., Russi E.W. et al. Effects of continuous positive airway plressure therapy with drawal in patients with obstructive sleep apnea: A randomized controlled trial. Am. J. Respir. Crit. Care Med. 2011;184(10):1192–1199. DOI: 10.1164/rccm.201106-0964OC.Jullian-Desayes I., Joyeux-Faure M., Tamisier R., Launois S., Borel A.L., Levy P. et al. Impact of obstructive sleep apnea treatment by continuous positive airway pressure on cardiometabolic biomarkers: A systematic review from sham CPAP randomized controlled trials. Sleep Med. Rev. 2015;21:23–38. DOI: 10.1016/j.smrv.2014.07.004. Epub 2014 Jul 31.Jullian-Desayes I., Joyeux-Faure M., Tamisier R., Launois S., Borel A.L., Levy P. et al. Impact of obstructive sleep apnea treatment by continuous positive airway pressure on cardiometabolic biomarkers: A systematic review from sham CPAP randomized controlled trials. Sleep Med. Rev. 2015;21:23–38. DOI: 10.1016/j.smrv.2014.07.004. Epub 2014 Jul 31.Peker Y., Glantz H., Eulenburg C., Wegscheider K., Herlitz J., Thunström E. Effect of positive airway pressure on cardiovascular outcomes in coronary artery disease patients with nonsleepy obstructive sleep apnea. The RICCADSA Randomized Controlled Trial. Am. J. Respir. Crit. Care Med. 2016;194(5):613–620. DOI: 10.1164/rccm.201601-0088OC.Peker Y., Glantz H., Eulenburg C., Wegscheider K., Herlitz J., Thunström E. Effect of positive airway pressure on cardiovascular outcomes in coronary artery disease patients with nonsleepy obstructive sleep apnea. The RICCADSA Randomized Controlled Trial. Am. J. Respir. Crit. Care Med. 2016;194(5):613–620. DOI: 10.1164/rccm.201601-0088OC.McEvoy R.D., Antic N.A., Heeley E., Luo Y., Ou Q., Zhang X. et al. CPAP for prevention of cardiovascular events in obstructive sleep apnea. N. Engl. J. Med. 2016;375(10):919–931. DOI: 10.1056/NEJMoa1606599.McEvoy R.D., Antic N.A., Heeley E., Luo Y., Ou Q., Zhang X. et al. CPAP for prevention of cardiovascular events in obstructive sleep apnea. N. Engl. J. Med. 2016;375(10):919–931. DOI: 10.1056/NEJMoa1606599.Parsons C., Allen S., Parish J., Mookadam F., Mookadam M. The efficacy of continuous positive airway pressure therapy in reducing cardiovascular events in obstructive sleep apnea: A systematic review. Future Cardiol. 2017;13(4):397–412. DOI: 10.2217/fca-2017-0004.Parsons C., Allen S., Parish J., Mookadam F., Mookadam M. The efficacy of continuous positive airway pressure therapy in reducing cardiovascular events in obstructive sleep apnea: A systematic review. Future Cardiol. 2017;13(4):397–412. DOI: 10.2217/fca-2017-0004.Yu J., Zhou Z., McEvoy R.D., Anderson C.S., Rodgers A., Perkovic V. et al. Association of Positive Airway Pressure with Cardiovascular Events and Death in Adults With Sleep Apnea: A Systematic Review and Meta-analysis. JAMA. 2017;318(2):156–166. DOI: 10.1001/jama.2017.7967.Yu J., Zhou Z., McEvoy R.D., Anderson C.S., Rodgers A., Perkovic V. et al. Association of Positive Airway Pressure with Cardiovascular Events and Death in Adults With Sleep Apnea: A Systematic Review and Meta-analysis. JAMA. 2017;318(2):156– 166. DOI: 10.1001/jama.2017.7967.Labarca G., Dreyse J., Drake L., Jorquera J., Barbe F. Efficacy of continuous positive airway pressure (CPAP) in the prevention of cardiovascular events in patients with obstructive sleep apnea: Systematic Review and Meta-analysis. Sleep Med. Rev. 2020;52:101312. DOI: 10.1016/j.smrv.2020.101312.Labarca G., Dreyse J., Drake L., Jorquera J., Barbe F. Efficacy of continuous positive airway pressure (CPAP) in the prevention of cardiovascular events in patients with obstructive sleep apnea: Systematic review and meta-analysis. Sleep Med. Rev. 2020;52:101312. DOI: 10.1016/j.smrv.2020.101312.Abuzaid A.S., Al Ashry H.S., Elbadawi A., Ld H., Saad M., Elgendy I.Y. et al. Meta-analysis of cardiovascular outcomes with continuous positive airway pressure therapy in patients with obstructive sleep apnea. Am. J. Cardiol. 2017;120(4):693–699. DOI: 10.1016/j.amjcard.2017.05.042.Abuzaid A.S., Al Ashry H.S., Elbadawi A., Ld H., Saad M., Elgendy I.Y. et al. Meta-analysis of cardiovascular outcomes with continuous positive airway pressure therapy in patients with obstructive sleep apnea. Am. J. Cardiol. 2017;120(4):693–699. DOI: 10.1016/j.amjcard.2017.05.042.Peker Y., Strollo P. Jr. A meta-analysis of positive airway pressure treatment for cardiovascular prevention: Why mix apples and pears? Evid. Based Med. 2017;22(6):218–219. DOI: 10.1136/ebmed-2017-110835.Peker Y., Strollo P. Jr. A meta-analysis of positive airway pressure treatment for cardiovascular prevention: Why mix apples and pears? Evid. Based Med. 2017;22(6):218–219. DOI: 10.1136/ebmed-2017-110835.Parra O., Sanchez-Armengol A., Capote F., Arboix A., Campos-Rodríguez F., Pérez-Ronchel J. et al. Efficacy of continuous positive airway pressure treatment on 5-year survival in patients with ischaemic stroke and obstructive sleep apnea: A randomized controlled trial. J. Sleep Res. 2015;24(1):47–53. DOI: 10.1111/jsr.12181.Parra O., Sanchez-Armengol A., Capote F., Arboix A., Campos-Rodríguez F., Pérez-Ronchel J. et al. Efficacy of continuous positive airway pressure treatment on 5-year survival in patients with ischaemic stroke and obstructive sleep apnea: A randomized controlled trial. J. Sleep Res. 2015;24(1):47–53. DOI: 10.1111/jsr.12181.Beaudin A.E., Hanly P.J., Raneri J.K., Sajobi T.T., Anderson T.J., Poulin M.J. Vascular responses to hypoxia are not impaired in obstructive sleep apnoea patients free of overt cardiovascular disease. Exp. Physiol. 2019;104(4):580–600. DOI: 10.1113/EP086845.Beaudin A.E., Hanly P.J., Raneri J.K., Sajobi T.T., Anderson T.J., Poulin M.J. Vascular responses to hypoxia are not impaired in obstructive sleep apnoea patients free of overt cardiovascular disease. Exp. Physiol. 2019;104(4):580–600. DOI: 10.1113/EP086845.Quan W., Zheng D., McEvoy R.D., Barbe F., Chen R., Liu Z. et al.; SAVE Investigators. High risk characteristics for recurrent cardiovascular events among patients with obstructive sleep apnoea in the SAVE study. EClinicalMedicine. 2018;2–3:59–65. DOI: 10.1016/j.eclinm.2018.09.002.Quan W., Zheng D., McEvoy R.D., Barbe F., Chen R., Liu Z. et al.; SAVE Investigators. High risk characteristics for recurrent cardiovascular events among patients with obstructive sleep apnoea in the SAVE study. EClinicalMedicine. 2018;2–3:59–65. DOI: 10.1016/j.eclinm.2018.09.002.Mazaki T., Kasai T., Yokoi H., Kuramitsu S., Yamaji K., Morinaga T. et al. Impact of sleep-disordered breathing on long-term outcomes in patients with acute coronary syndrome who have undergone primary percutaneous coronary intervention. J. Am. Heart Assoc. 2016;5(6):e003270. DOI: 10.1161/JAHA.116.003270.Mazaki T., Kasai T., Yokoi H., Kuramitsu S., Yamaji K., Morinaga T. et al. Impact of sleep-disordered breathing on long-term outcomes in patients with acute coronary syndrome who have undergone primary percutaneous coronary intervention. J. Am. Heart Assoc. 2016;5(6):e003270. DOI: 10.1161/JAHA.116.003270.Mazaki T., Kasai T., Yokoi H., Kuramitsu S., Yamaji K., Morinaga T. et al. Impact of sleep-disordered breathing on long-term outcomes in patients with acute coronary syndrome who have undergone primary percutaneous coronary intervention. J. Am. Heart Assoc. 2016;5(6):e003270. DOI: 10.1161/JAHA.116.003270.

The authors declare that there are no conflicts of interest present.