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Vol. 45. Issue S3.
Controversias de formación en neumología
Pages 14-21 (March 2009)
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Vol. 45. Issue S3.
Controversias de formación en neumología
Pages 14-21 (March 2009)
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El síndrome de apnea-hipopnea del sueño en 2009
Sleep apnea-hypopnea syndrome 2009
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Ana Camarasa Escriga, Demetrio González Vergarab, José Carlos Serrano Rebolloc, Ferran Barbéd,
Corresponding author
fbarbe@arnau.scs.es

Autor para correspondencia.
a Hospital Universitario San Juan de Alicante, Alicante, España
b Hospital Universitario Virgen del Rocío, Sevilla, España
c Hospital San Pedro de Alcántara, Cáceres, España
d Hospital Universitario Arnau de Vilanova, Lleida, España. CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid. IRB Lleida, Lleida, España
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Resumen

El síndrome de apnea-hipopnea del sueño (SAHS) es una entidad con una elevada prevalencia en la población general que, debido a su repercusión sociosanitaria, se ha convertido en un problema de salud pública de primera magnitud. La definición del síndrome ha ido evolucionando, así como la definición de acontecimiento respiratorio. El papel de los mecanismos inflamatorios en el desarrollo de enfermedad cardiovascular se encuentra en plena investigación y es probable que en el futuro haya que añadir marcadores biológicos tanto en la definición del síndrome como en la elección del tratamiento. Aunque la técnica de referencia en el diagnóstico es la polisomnografía, la poligrafía respiratoria se ha convertido en una alternativa válida y complementaria al tratarse de un método simplificado, que puede realizarse en el domicilio, para descartar o confirmar la enfermedad. Sistemas expertos como el monocanal quizá aporten nuevos datos en la simplificación del diagnóstico. Actualmente el tratamiento con presión positiva continua de la vía aérea (CPAP) sigue siendo el método de referencia y su indicación principal en pacientes con SAHS moderado o severo en los cuales ha demostrado disminuir la mortalidad.

Palabras clave:
Diagnóstico
Poligrafía respiratoria
Polisomnografía
Síndrome de apnea-hipopnea del sueño
Tratamiento
Abstract

Sleep apnea-hypopnea syndrome (SAHS) is a highly prevalent disease in the general population and, due to its social and health repercussions, has become a major public health problem. The definition of this syndrome, as well as that of respiratory event, have been refined.

The role of inflammatory mechanisms in the development of cardiovascular disease is currently under investigation and biological markers will probably be added, both in the definition of SAHS and in the choice of treatment. Although the gold standard in diagnosis is polysomnography, respiratory polygraphy has become a valid and complementary alternative, since this technique is a simplified method that can be performed in the home to confirm or exclude this disease. Expert systems such as single-channel devices may help to simplify diagnosis. Currently, the mainstay of treatment is still continuous positive airway pressure (CPAP); this modality is mainly indicated in patients with moderate or severe SAHS and has been shown to reduce mortality in this group.

Keywords:
Diagnosis
Respiratory polygraphy
Polysomnography
Sleep apnea-hypopnea syndrome
Treatment
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Bibliografía
[1.]
C. Guilleminault, A. Tilkian, W.C. Dement.
The sleep apnea syndromes.
Annu Rev Med, 27 (1976), pp. 465-485
[2.]
G.A. Gould, K.F. Whyte, G.B. Rhind, M.A. Airlie, J.R. Catterall, C.M. Shapiro, et al.
The sleep hypopnea syndrome.
Am Rev Respir Dis, 137 (1988), pp. 895-898
[3.]
A manual of standardized terminology, techniques and scoring system of sleep stages in human subjects,
[4.]
M.H. Silber, S. Ancoli-Israel, M.H. Bonnet, S. Chokroverty, M.M. Grigg-Damberger, M. Hirshkowitz, et al.
The visual scoring of sleep in adults.
J Clin Sleep Med, 3 (2007), pp. 121-131
[5.]
D. Moser, P. Anderer, G. Gruber, S. Parapatics, E. Loretz, M. Boeck, et al.
Sleep classification according to AASM and Rechtschaffen & Kales: effects on sleep scoring parameters.
Sleep, 32 (2009), pp. 139-149
[6.]
Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research.
The Report of an American Academy of Sleep Medicine Task Force.
Sleep, 22 (1999), pp. 667-689
[7.]
W.R. Ruehland, P.D. Rochford, F.J. O’Donoghue, R.J. Pierce, P. Singh, A.T. Thornton, et al.
The new AASM criteria for scoring hipopneas: impact on the apnea-hypopnea index.
Sleep, 32 (2009), pp. 150-157
[8.]
F.J. Nieto, T.B. Young, B.K. Lind, E. Shahar, J.M. Samet, S. Redline, et al.
Association of sleep-disordered breathing, sleep apnea and hypertension in a large communitybased study. Sleep Heart Health Study.
JAMA, 283 (2000), pp. 1829-1836
[9.]
I. Alam, K. Lewis, J.W. Stephens, J.N. Baxter.
Obesity, metabolic syndrome and sleep apnea: all pro-inflammatory states.
Obesity Rev, 8 (2006), pp. 119-127
[10.]
A.I. Pack, T. Gislason.
Obstructive sleep apnea and cardiovascular disease: a perspective and future directions.
Prog Cardiovasc Dis, 51 (2009), pp. 434-451
[11.]
A. Williams, S.M. Scharf.
Obstructive sleep apnea, cardiovascular disease, and inflammation–is NF-kappaB the key?.
Sleep Breath, 11 (2007), pp. 69-76
[12.]
J. Durán, F.J. Puertas, G. Pin-Arboledas, J. Santa María, Grupo Español de Sueño (GES).
Documento de Consenso Nacional sobre el SAHS.
Arch Bronconeumol, 41 (2005), pp. S1-S110
[13.]
Standard of Practice Committee of the American Sleep Disorders Association.
Practice parameters for the use of portable recording in the assessment of obstructive sleep apnoea.
Sleep, 139 (1994), pp. 559-568
[14.]
N.J. Douglas, S. Thomas.
Clinical value of polysomnography.
Lancet, 339 (1992), pp. 347-350
[15.]
E. García, F. Capote, S. Cano.
Poligrafía respiratoria ambulatoria en el diagnóstico del síndrome de apnea obstructiva del sueño.
Arch Bronconeumol, 33 (1997), pp. 2
[16.]
J. Duran, F. Barbé, et al.
Disponibilidad de recursos técnicos para el diagnóstico y tratamiento en los hospitales del estado español.
Arch Bronconeumol, 3131 (1995), pp. 463-469
[17.]
H. Buchwald, Y. Avidor, E. Braunwald, M.D. Jensen, W. Pories, K. Fahrbach, et al.
Bariatric surgery: a systematic review and meta-analysis.
JAMA, 292 (2004), pp. 1724-1737
[18.]
Smith I, Lasserson TJ, Wright J. Farmacoterapia para la apnea obstructiva del sueño en adultos (Revisión Cochrane traducida). En: La Biblioteca Cochrane Plus, 2008 Número 2. Oxford: Uptodate Software Ltd. Disponible en: http://www.updatesoftware.com (traducida de The Cochrane Library, 2008 Issue 2, Chichester, UK: John Wiley & Sons, Ltd.).
[19.]
V. Hoffstein.
Review of oral appliances for treatment of sleep-disordered breathing.
Sleep Breath, 11 (2007), pp. 1-22
[20.]
M. Friedman, H.C. Lin, B. Gurpinar, N.J. Joseph.
Minimally invasive single stage multilevel treatment for obstructive sleep apnoea/hypopnea syndrome.
Laryngoscope, 117 (2007), pp. 1859-1863
[21.]
N.S. Marshall, K. Wong, P.Y. Liu, S.R. Cullen, M.W. Knuiman, R.R. Grunstein.
Sleep apnea as an independent risk factor for all-cause mortality: The Busselton Health Study.
Sleep, 31 (2008), pp. 1079-1085
[22.]
J.M. Marin, S.J. Carrizo, E. Vicente, A.G. Agusti.
Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnea with or without treatment with continuous positive airway pressure: an observational study.
Lancet, 365 (2005), pp. 1046-1053
[23.]
T. Young, L. Finn, P.E. Peppard, M. Szklo-Coxe, D. Austin, F.J. Nieto, et al.
Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort.
Sleep, 31 (2008), pp. 1071-1078
Copyright © 2009. Sociedad Española de Neumología y Cirugía Torácica
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