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Introduction. In recent years, there has been evidence not only of the widespread prevalence of the obstructive sleep apnea (OSA) in the population, but also of the progression of the disease in the dynamic follow-up of patients. The purpose of this review article is to analyze the current state of etiopathogenesis, clinics of obstructive sleep apnea and to identify more promising treatment approaches and risk factors for its development. Materials and methods. The analysis of publications was performed for the period 2016-2021 on the basis of data from Elibrary, the Federal Electronic Medical Library of the Ministry of Health of the Russian Federation, the bibliographic database of medical publications MEDLINE, created by the US National Library of Medicine. Sixty-one sources were selected for the review. Results and discussion. Obstructive sleep apnea is widely represented in the group of sleep disorders and is correlated with a number of clinical conditions: cardiovascular diseases (acute cerebrovascular disease, resistant arterial hypertension, coronary heart disease, heart rhythm disorder), endocrine system (diabetes mellitus, hypothyroidism, metabolic syndrome, obesity), ophthalmological pathology (neurooptikopathies), sudden death, etc. Severe daytime sleepiness due to OSA is not only a medical but also a social problem due to increased injury rates, accidents at work and on the road, and decreased labor productivity. Conclusion. The introduction of a comprehensive interdisciplinary approach to diagnostic standards will improve the detection and treatment of obstructive sleep apnea and improve the quality of life of patients. Change of lifestyle and use of PAP-therapy in patients with OSA is currently the most adequate direction in the treatment of this pathology. High prevalence, serious consequences for the nation's health and economy dictate the need for further study of markers of this disease for early prediction and primary prevention of cardiovascular diseases and diseases associated with obstructive sleep apnea.

The human functional state is a prognostic indicator of the performance measurement. It is determined by the degree of activation of all body systems involved in a certain activity. The success of such an activity depends on the backup capabilities of the central nervous system. Afferent information triggers certain motor programs and activates those CNS parts, which control and correct such programs. The coordination of motor action sensory and motor components is an essential condition for sensory system functioning. The evaluation of visual and motor reactions is the simplest and most popular method, which reflects the speed of nervous processes, their switching, the level of visual-motor coordination, the general level of CNS efficacy and activity. The technique, which determines the parameters of various visual-motor reactions, characterizes the excitability of the visual analyzer cortical section, the excitation rate along the reflex arc to the effector inclusively, and contractile function. The time from the signaling to the body response is spent on data conducting and processing in the most complex parts of the brain and, therefore, serves as an indicator of the CNS functional state. The purpose of this paper is to highlight the method of evaluating the parameters of visual-motor reactions as integral indicators of the CNS functional state. Literarure data analysis has shown that indicators of visual-motor reactions characterize the state of the nervous processes in the body and its individual and typological characteristics. Moreover, they are considered as integral indicators of the CNS functional state. Assessment of visual-motor reactions is a simple and accurate neurophysiological indicator of the CNS neurodynamic characteristics, the overall performance level and CNS activity, which determines its prevalence in the study of human psychomotor functions. Keywords: simple and complex visual-motor reactions, CNS functional state. Функциональное состояние человека является прогностическим показателем оценки его работоспособности и определяется степенью активации всех систем организма, задействованных в исследуемом виде деятельности, успешность которой во многом зависит от резервных возможностей центральной нервной системы. Афферентная информация запускает определенные двигательные программы и активирует отделы центральной нервной системы, которые ответственны за контроль над этими программами и их корректировку. Координация сенсорных и моторных компонентов двигательного акта является важнейшим условием функционирования сенсорной системы. Наиболее простым и доступным методом, отражающим динамику скорости нервных процессов, их переключение, уровень зрительно-моторной координации, общий уровень работоспособности и активности центральной нервной системы, является оценка характеристик зрительно-моторных реакций. Методика определения параметров зрительно-моторных реакций различного уровня сложности характеризует возбудимость коркового отдела зрительного анализатора, скорость проведения возбуждения по рефлекторной дуге до эффектора включительно и сократительную функцию. Время от начала подачи сигнала до ответной реакции организма затрачивается на проведение и обработку информации в высших отделах мозга и поэтому служит показателем функционального состояния центральной нервной системы. Цель настоящей статьи – осветить распространенность использования метода оценки параметров зрительно-моторных реакций как интегральных показателей функционального состояния центральной нервной системы. Анализ исследовательских работ показал, что показатели зрительно-моторных реакций характеризуют состояние нервных процессов организма и его индивидуально-типологические особенности и рассматриваются как интегральные показатели функционального состояния центральной нервной системы. Оценка зрительно-моторных реакций является достаточно простым и точным нейрофизиологическим индикатором нейродинамических свойств нервной системы, общего уровня работоспособности и активности центральной нервной системы, что обусловливает распространенность его использования в области исследования психомоторных функций человека. Ключевые слова: простые и сложные зрительно-моторные реакции, функциональное состояние центральной нервной системы.

The aim: to study the peculiarities of central hemodynamics and erythrocyte parameters under the influence of extreme occupational factors in firefighters with different lifetimes in the Federal Fire Service (FPS) of the Ministry of Emergency Measures for the Tver Region. Methods: 240 firefighters (age 25-47 years) were divided into three groups depending on the length of service: 1-6, 7-15, 16-25 years. Parameters of central hemodynamics were determined at the beginning of the working day shift according to the method of tetrapolar thoracic rheography. The absolute content of red blood cells in capillary blood was counted using a blood analyzer. Special techniques were used to determine deformability of their membrane. Results: most hemodynamic parameters deviated from the statutory values in the first group in comparison with other groups. This was regarded as an imbalance between the volume-time indeces of the blood circulation and the organism's needs under conditions of extreme occupational stress. Gradual formation of an adequate hemodynamic profile was detected with an increase in the length of service. This allows us to conclude about the mobile and reactive nature of hemodynamic changes in the body. Expressed hematologic changes, manifested in a decrease in the erythrocyte membrane deformability and increase in its rigidity, were found in the third group. The observed patterns at the last stage of the service probably reflect the conservative nature of negative shifts development. Conclusion: comparison of the dynamics of physiological changes in firefighters-rescuers of three groups with different service life in the Ministry of Emergency Measures revealed the reactive nature of hemodynamic changes and the conservative nature of hematological manifestations.

The emotional state of a person affects both the central level and the peripheral indices of the autonomic nervous system, particularly those of the regulation of the heart rate. Our study showed that boys with a higher level of anxiety had higher values of the latent period of the P300 evoked potential and lower indices of short-term auditory memory. Changes in the temporal and spectral components of heart rate variability under the conditions of mental workload indicate that the neurohumoral regulation of the heart rate is shifted toward the suprasegmental influences, including pituitary–hypothalamic and cortical influences.

240 hot papas (age 25-47 years) took part in the research. They were divided into three groups depending on the length of service: 1-6, 7-15, 16-25 years. Red blood cells parameters were examined by means of the blood analyzer "Micros-60 OT", membrane deformability and osmotic fragility were determined according to special techniques at the beginning and at the end of the daily shift. The morphometric parameters of hot papas' erythrocytes corresponded to normal values. The workload during the day did not lead to their significant shifts except anisocytosis in the group with work experience of 16-25 years. The influence of service duration on increase of red blood cell heterogeneity, a reduction in their total number and Hb level was found in the same group. At the beginning of the shift the membrane deformability and osmotic fragility in 0.45 % NaCl solution were significantly lower in all surveyed groups than in the control group. The average values of these parameters increased in all groups by end of the shift. However, the control group values were not achieved.

This review presents modern data on the biorhythms of cardiac activity in healthy individuals and pathological conditions. The article presents the changes in the indices of the cardiovascular system during the day. There are diurnal patterns in changes of heart rate. As in healthy persons and in patients suffering from arterial hypertension bimodality circadian rhythm of blood pressure was revealed. It is emphasized that circadian fluctuations in blood pressure may be associated with the participation of melatonin in the regulation of this indicator of cardiovascular activity. In healthy people circadian fluctuations of intervals duration and the height of ECG waves have been revealed. The people belonging to a certain chronotype influence diurnal variations of indicators of heart rate variability. The results of seasonal fluctuations of indicators of cardiac activity as well as the analysis of the frequency of disease recurrence in different periods of the year, the seasons and during the day are presented. The article describes research data on the effect of natural abiotic stress factors - geomagnetic disturbances on chronostructure biorhythms of the heart. The changes in blood pressure and heart rate in the voltage amplification of the magnetic field of the Earth have been covered. The statistical data proving connection between the heliogeomagnetic activity and an increase in the number cardiovascular accidents have been presented. Using the basic regularities of chronobiology allows us to predict the risk of developing various diseases, primarily cardiovascular diseases, which are the main reason of mortality in the world.

According to the classical and modern concepts the organization of functional hemispheric asymmetry is an interesting issue for different specialists. This article reviews current data on fixed and dynamic properties of the cerebral hemispheres functional specialization. The article covers the issues of functional insufficiency of hemispheric interrelations associated with some diseases, gives comparative analysis of parameters of social and psychological adaptation of individuals with one-hemisphere dominance, and presents features of lateralization of brain function in healthy males and females and those with pathology. The authors emphasize the leading role of the corpus collosum in hemispheric interrelations, reveal the features of hemispheric asymmetry of right-handed and left-handed individuals based on interaction of the cortex and the brain regulatory systems during quiet wake, dynamism and falling asleep. The article also focuses on the features of brain function lateralization of some athletes and hemispheric interrelations in different phases of desynchronosis and during organism ageing in normal and stressful ecological conditions. The authors address the issue of the relationship of pregnancy and the brain lateralization, as well as the functional specialization of the cerebral hemispheres with the asymmetry of the autonomic nervous system.

The article compares different authors' methods of diagnosis of connective tissue dysplasia in children on the basis of phenotypic and visceral markers. The benign joint hypermobility syndrome in children of different ages in Tver was diagnosed using the Beighton method: it was detected in 71% of children under 7 years old and in 31.1% of older children. The benign joint hypermobility syndrome is typical of practically all children from 3 to 4 years old and of the majority of children from 5 to 7 years old, which indicates that increased flexibility is a physiologic standard for this age and that the Beighton method does not detect accurately the abnormality of connective tissue in children under 7 years old. 120 children have been examined for presence and severity of connective tissue dysplasia using three different ways at the same time and also using different authors' methods and diagnostic tables. The method of T.I. Cadurina detects presence of connective tissue dysplasia 1.5 times more often than the methods of T. Milkowska-Dimitrova and A. Karkashov. The results when using the method of L.N. Abbakumova are in between. The conclusion of the article shows that diagnosis of connective tissue dysplasia in children cannot be based only on identification of the benign joint hypermobility syndrome, and the methods of diagnosis of connective tissue pathology taking into account not only external but also internal markers are more accurate. Common methods of calculating frequency of connective tissue pathology in children must be applied in all regions of our country.

Personal adaptive capacity was evaluated in 248 firefighters (age 20-29 years) of the Tver region upon entering employment and after a year of service. Using the psychodiagnostic complex "Multipsikhometr-05", three indicators of psychophysiological techniques (preparedness for emergency action, plasticity and tolerance of the nervous system) were studied. It has been detected that the PAC level of all the respondents was high. The PAC level decreased significantly in 25 % of the firefighters (the risk group) and remained high in 75 % of the respondents (the main group) after a year of service. The values of preparedness for emergency action for all the firefighters were high throughout the year. The average values of plasticity of the nervous system had initial significantly lower rates in the firefighters of the risk group in comparison with the main group. After a year of service, the average values of the parameters of the techniques of plasticity and tolerance of the nervous system decreased significantly in the risk group. With the ANOVA use, it has been found that plasticity of the nervous system was the only significant PAC psychophysiological predictor. This indicator is recommended to be used in firefighters' professional selection and annual monitoring of their psychological state.

A review of data on morpho-functional features of disease course in subjects of various ethnic and race belonging in presented in the article. These features are due to genetic, cultural, socio-economic and environmental factors.

The pulmonary disease reduces all parameters of quality of life. Using a questionnaire of WHO Q0L-100, there has been performed a study of parameters of quality of life in patients with fibro-cavernous and focal forms of pulmonary tuberculosis. Mean values of different areas of quality of life in patients with fibro-cavernous pulmonary tuberculosis were 2-3 times (p ≤ 0,01) lower than those in patients with focal tuberculosis. The patients in both groups suffered morally mostly. It has been revealed that tuberculous patients with a favorable clinical prognosis had a moderate decrease in the level of well-being and satisfaction with conditions of life. The analysis of the values of the exponent falsity according to the questionnaire by V. G. Norakidze (1975) has detected that all respondents answered the proposed questions quite truthfully, as values on the scale of falsity did not exceed 6 points. The results of the study of the parameters of the tuberculous patients’ quality of life can be used for targeted psycho-social rehabilitation with regard to the form of the disease.

The list of lichen species includes 231 species found in the lower course of the rivers Chegitun and Utaveem in the north-eastern part of Chukotka Peninsula. The peculiarity of the region is a wide distribution of epiphytic and calcareous lichens in comparison with the other regions of Chukothka Peninsula.

A list of 36 lichen species new to Yaroslavl Region is given. Thus the total list of lichens of the area comprises 234 species.

Lipid components in various brain structures undergo different changes during geomagnetic perturbations. These changes involve synthetase, hydrolase, and transferase biotransformations of lipids. These changes reflect differences in metabolic activities in the left and right cerebral hemispheres and the development of biochemical cerebral asymmetry under the effect of natural stress factors. Changes in lipid metabolism probably reduce adaptive capacities of the organism.

Experiments in cats revealed a clear-cut dependence of the early complex (up to 100 msec) of evoked potentials recorded in the caudate nucleus and temporal cortex on biological relevance of the stimulus (presence or absence of alimentary signal), with constant physical parameters. The early complex of evoked potentials can reflect activity of the mechanisms preventing non-specific motor response to exteroceptive stimulus, although it does not exclude processing the stimulus-carried information during generation of evoked potentials.

Duodenal ulcer is characterized by certain recurrence and occurs more often in men than in women. One can assume that functional changes, which are characterized by the seasonal nature and sex differences, play some role in its pathogenesis. There was a study of the duodenogastric reflux role in the pathogenesis of duodenal ulcer. It was revealed that duodenal reflux is provoked in about one half of patients sent for an endoscopic examination, less frequently--in spring and autumn, and least of all--in male patients with duodenal ulcer during seasons of the maximum frequency of duodenal ulcer exacerbations. The frequency of duodenogastric reflux provocation went down on days of geomagnetic storms. One could observe certain dependence between the extent and duration of reflux, on the one hand, and clinical registration of the disease, on the other hand.

Geomagnetic effects on quantitative characteristics of alpha-rhythm were assessed by shifts in electroencephalograms recorded in 126 essentially healthy human subjects and changes in lipid metabolism in the cortex and white matter in 140 white rats. Indices of the geomagnetic activity were D, H and Z-components. The method of "epoch superposition" revealed an inconsistent alpha-rhythm depression and flattening out of the interhemispheric functional asymmetry against persistently high electrical activity in the right hemisphere, and biochemical asymmetry in consequence of different lipid transformation processes. Spotlighted were some nonspecific adaptive reactions to changes in the environment and stressful agents.

Changes in a number of respiration and circulation parameters during magnetic storms of varying intensity were analyzed in 126 normal humans belonging to two age groups: 19-21 yr. old young men and women (29 of each) and 51-53 yr. old men (n = 36) and women (n = 32). Geomagnetic components D, H and Z were used. Systolic pressure, respiration volume, minute respiration volume and peak expiration rate were shown to be the most labile characteristics of the cardiorespiratory system responding by increases on magnetodisturbed days. The parameters under study exhibited sexual and age differences equally on quiescent and magnetodisturbed days. Adaptation to growing tension of the magnetic field of Earth involves the neuroendocrine system and manifests itself by activation of the sympathetic nervous system entailing relative shifts in the cardiorespiratory parameters under study.

Geomagnetic effects on concentrations of lipids in the rats' white substance, subcortical structure (neostriatum) and blood were studied. Lipids in the brain and blood samples were investigated with the thin-layer chromatography. Indices D, H and Z served as characteristics of the geomagnetic activity. On the days of magnetic disturbances counts of brain and blood lipids were found to alter. The results suggest that changes in concentration of lipids, phospholipids as the most important components of biomembrane in the first place, are liable to impact their metabolism and, consequently, adaptability of organism.

Studied was the central cardiac rhythm control with the use of the statistical indices of cardiac cycle length (variation range, mode, mode amplitude) on the background of altered activity of Earth's magnetic field as judged by the D, H and Z constituents. Subjects were 36 essentially healthy humans of two age groups: 19-23-yr. old (group-I) and 51-53-yr. old (group-II). During magnetic storms the strain index increased in 44.4% and 66.6% of the members of groups I and II, respectively. In group I, this parameter rose by 60 +/- 5.8% and in group II, by 85.6 +/- 8.8%. Changes in the indices were more pronounced in group II. Males are more sensitive to alterations in the magnetic field strain. There were no subjective sensations despite the registered magnetobiological reactions. Results of the investigation showed that magnetic storms are associated with higher activity of the sympathoadrenal and hypothalamus--pituitary body--adrenals systems which is indicative of recruitment of defense mechanisms and functional strain.

Investigated was an impact of geomagnetic activity on incidence of "independent" early (up to 100 ms) evoked potentials (EP only in one of the hemispheres) in the head of tailed nucleus (TNH) and temporal cortex (TC) in 17 cats in the course of elaboration of food-rewarded instrumental reflex to an acoustic stimulus (click, 85 dB). Intensity of the geomagnetic activity was determined by values of the D-, H-, and Z-indices. The following 3 groups of animals were identified by the limbs dominating in implementation of the conditioned reflex: I--dextral (n = 11), II--sinistral (n = 3) and III--ambidextral (n = 3). The majority of animals in groups I and II displayed significantly higher values of "independent" EP in the left and right hemisphere, respectively, on magnetically quiescent days. On magnetically disturbed days the dextral animals would significantly increase this parameter both in TNH and TC of the right hemisphere, whereas the sinistral animals maintained the parameter high in the right hemisphere. The data suggest stimulation by increased geomagnetic activity of the right hemisphere which is more tightly bonded with diencephalic structures. Activation of the diencephalic structures and associated right-hemisphere asymmetry resulting from the bioelectrical activity in response to the tone may be indicative of rearrangement of neurohumoral interrelations due to changed difference of the terrestrial magnetic field potential as adaptive self-regulation of the function.

Lipid components in various brain structures undergo different changes during geomagnetic perturbations. These changes involve synthetase, hydrolase, and transferase biotransformations of lipids. These changes reflect differences in metabolic activities in the left and right cerebral hemispheres and the development of biochemical cerebral asymmetry under the effect of natural stress factors. Changes in lipid metabolism probably reduce adaptive capacities of the organism.

Impacts of geomagnetic disturbances on parameters of an early complex of evoked potentials (EP, up to 100 ms) in the temporal cortex (TC) and the head of caudate nucleus (HCN) due to the auditory stimulus (click, 85 dB) were evaluated in 12 conscious cats. Mean values of the peak time amplitude, expressiveness of each component and latent period were determined. Indices D, H and Z were used to evaluate the magnetic activity. Experimental animals in group-1 displayed an increase in latency of cortical EP against weakened EP expressiveness in the right hemisphere. In HCN EP expressiveness showed a rise in the left hemisphere. In group-2, the latent period of cortical EP grew in parallel to the amplitude and peak negative component. The latent period of caudal EP diminished whereas expressiveness and amplitude of EP components increased. The data suggest that geomagnetic disturbances suppress the cortical reactivity to exteroceptive stimuli and raise the functional activity of the cerebral inhibitory components, as is the caudate nucleus.

Experiments in cats revealed a clear-cut dependence of the early complex (up to 100 msec) of evoked potentials recorded in the caudate nucleus and temporal cortex on biological relevance of the stimulus (presence or absence of alimentary signal), with constant physical parameters. The early complex of evoked potentials can reflect activity of the mechanisms preventing non-specific motor response to exteroceptive stimulus, although it does not exclude processing the stimulus-carried information during generation of evoked potentials.

In 27 men who had undergone chronic intoxication with carbon disulfide, the shock ejection, heart rate, minute blood volume, phase analysis of left ventricular systole were examined; the amplitude-time parameters were determined: the rate of cardiac output, the rate of pressure rise and the rate of cardiac relaxation. The parameters of hemodynamics at rest and their change in response to increasing static strengthening of the right hand were studied. The most informative parameters for detecting heart failure in chronic carbon disulfide intoxication were amplitude-time parameters.