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Chronobiology in Medicine 2019;1(1):9-13.
DOI:    Published online March 15, 2019.
Obstructive Sleep Apnea and Chronic Lung Disease
Woo Ho Ban1  , Sang Haak Lee2 
1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
2Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, St. Paul’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
Correspondence:  Sang Haak Lee, Tel: 82-2-961-4500, Fax: 82-2-968-7250, 
Received: 4 January 2019   • Revised: 15 January 2019   • Accepted: 28 January 2019
Idiopathic pulmonary fibrosis (IPF) and chronic obstructive pulmonary disease (COPD) are chronic disabling lung diseases that progress slowly in the elderly and are characterized by remodeling of the lung interstitium or bronchoalveolar structure. Patients with IPF or COPD have various comorbidities such as pulmonary arterial hypertension, ischemic heart disease, sleep-disordered breathing, and even cancer. Chronic hypoxia is one of the most important mechanisms in these patients and promotes changes in the lung parenchyma and vascular structure via systemic inflammation and endothelial dysfunction. Research on sleep disturbance in IPF and COPD has been vigorously conducted, and there have been reports in recent years that have suggested that obstructive sleep apnea (OSA) is closely related to disease progression and poor clinical outcomes in these two diseases. Intermittent hypoxia (IH), a key mechanism of OSA, induces further systemic inflammation and sympathetic overactivity, which may aggravate disease progression in IPF and COPD, which characteristically predispose to chronic hypoxia. Epidemiologic and experimental evidence has shown that OSA and IH could be promising targets to prevent the progression of IPF and COPD. This review provides a possible pathological mechanism of OSA and IH and suggests their promising role as emerging targets for disease control in IPF and COPD.
Key Words: Sleep apnea; Obstructive; Pulmonary disease; Chronic obstructive; Idiopathic pulmonary fibrosis
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