Defisiensi vitamin D terhadap kejadian obstructive sleep apnea (OSA): tinjauan pustaka

https://doi.org/10.22146/bns.v20i3.106506

Ferias Dwi Sembodo(1*), Astuti Astuti(2), Indra Sari Kusuma Harahap(3)

(1) SMF Saraf RS PKU Muhammadiyah Petanahan, Kebumen
(2) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta/RSUP Dr. Sardjito
(3) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta/RSUP Dr. Sardjito
(*) Corresponding Author

Abstract


Obstructive Sleep Apnea (OSA) is a sleep-disordered breathing disorder characterized by recurrent upper airway obstruction, leading to hypoxia, daytime sleepiness, and increased risk of cardiovascular, cerebrovascular, and metabolic diseases. OSA has a significant prevalence, especially in men, obese individuals, and populations with certain risk factors. OSA is diagnosed through Polysomnography (PSG) examination that assesses the Apnea-Hypopnea Index (AHI). Recent studies have shown an association between OSA and low vitamin D levels. Several mechanisms linking these two conditions include decreased sunlight exposure due to daytime sleepiness, metabolic disorders in obesity, immune dysregulation, and airway muscle weakness due to vitamin D deficiency. On the other hand, low vitamin D levels can also worsen the severity of OSA through the mechanisms of gene polymorphism, chronic inflammation, and tonsil hypertrophy. OSA therapy involves the use of Continuous Positive Airway Pressure (CPAP), weight loss, and surgical intervention. Interestingly, long-term CPAP therapy can increase vitamin D levels in OSA patients, while vitamin D supplementation has been shown to improve sleep quality and reduce the severity of OSA. Given the complex bidirectional relationship between OSA and vitamin D deficiency, monitoring and management of vitamin D levels in OSA patients may be a useful additional strategy to improve clinical outcomes

 

ABSTRAK

Obstructive sleep apnea (OSA) adalah gangguan pernapasan saat tidur yang ditandai dengan obstruksi saluran napas atas berulang, menyebabkan hipoksia, kantuk di siang hari, serta peningkatan risiko penyakit kardiovaskular, serebrovaskular, dan metabolik. OSA memiliki prevalensi yang signifikan, terutama pada pria, individu obesitas, dan populasi dengan faktor risiko tertentu. Diagnosis OSA dilakukan melalui pemeriksaan polisomnografi (PSG) yang menilai indeks apnea-hipopnea (AHI). Studi terkini menunjukkan adanya hubungan antara OSA dan kadar vitamin D yang rendah. Beberapa mekanisme yang menghubungkan kedua kondisi ini meliputi penurunan paparan sinar matahari akibat kantuk siang hari, gangguan metabolisme pada obesitas, disregulasi imun, serta kelemahan otot saluran napas akibat defisiensi vitamin D. Di sisi lain, kadar vitamin D yang rendah juga dapat memperburuk keparahan OSA melalui mekanisme polimorfisme gen, inflamasi kronis, serta hipertrofi tonsil. Terapi OSA melibatkan penggunaan continuous positive airway pressure (CPAP), penurunan berat badan, hingga intervensi bedah. Menariknya, terapi CPAP jangka panjang dapat meningkatkan kadar vitamin D pada pasien OSA, sementara suplementasi vitamin D telah terbukti dapat memperbaiki kualitas tidur dan menurunkan tingkat keparahan OSA. Dengan hubungan dua arah yang kompleks antara OSA dan defisiensi vitamin D, pemeriksaan serta manajemen kadar vitamin D pada pasien OSA dapat menjadi strategi tambahan yang bermanfaat untuk meningkatkan hasil klinis


Keywords


OSA; vitamin D; polysomnography



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DOI: https://doi.org/10.22146/bns.v20i3.106506

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