บทคัดย่อ
Sleep disorders are known to have impact on health status. One of the most common sleep
disorders that have shown to be associated with significant comorbidities are obstructive sleep apnea. There
are many studies demonstrating that obstructive sleep apnea increases the risk of many cardiovascularrelated
diseases including hypertension, coronary artery disease, stroke, arrhythmia, congestive heart
failure, and insulin resistance. Other non‐cardiovascular‐related diseases also have shown clear association
with obstructive sleep apnea such as gastro‐esophageal reflux disease, erectile dysfunction, and depression.
Vice versa, we have demonstrated that the group with cardiovascular‐related diseases also is known to be
associated with more severe obstructive sleep apnea and may deserve obstructive sleep apnea screening 1.
We are also currently conducting several research studies on the impact of obstructive sleep apnea on
health status including the research on cognition of patients with moderate to severe obstructive sleep
apnea and impact of obstructive sleep apnea and its treatment on gestational diabetes mellitus. We
observed that interestingly Asians with obstructive sleep apnea have unique clinical characteristics with
relatively normal body mass index (BMI) compared to Caucasians 2. Predisposing craniofacial structure is
believed to have more impact on obstructive sleep apnea pathogenesis among Asians. Positional sleep
apnea, defined by significant reduction of at least 50% in obstructive respiratory events (respiratory
disturbance index or RDI) during non‐supine position when comparison was made with supine position is
very common among Asians and we reported a prevalence of up to 70% 3. Potential treatment besides
continuous positive airway pressure (CPAP) such as the use of positional therapy device or upper airway
muscle exercises may be of great benefit among Asians. We conducted a study demonstrated that upper
airway muscle exercises for 3 months significantly reduced obstructive events among moderate to severe
obstructive sleep apnea patients. We are also currently conducting a research on potential positional
therapy device as a novel treatment modality in Thai obstructive sleep apnea patients. However obstructive
sleep apnea is not the only sleep disorders effecting health status. Insufficient sleep syndrome and shift work
disorder are among the important entities. Both of these entities are shown to be associated with excessive
daytime sleepiness which is known to increase risk of motor vehicle collisions and work‐related accident. We
are currently conducting a study on uncovering the cause of sleepiness among junior doctors which we hope
to identify the prevalence of insufficient sleep syndrome, shift work disorder, and other sleep disorders in
this specific group. Despite sleep‐disordered research gaining more interest among the researchers in the
past few years, more research is still needed in order to discover its effect on health outcome, improve care
for our patients, and for our public safety.
