Situación en Navarra del diagnóstico y tratamiento en el síndrome de apneas-hipopneas obstructivas durante el sueño
Diagnosis and treatment of obstructive sleep apnea-hypopnea syndrome: the situation in Navarra (Spain)
J. Hueto
, J. Boldú, P. Cebollero, J.A. Cascante, J. Abu-Shams, V.M. Eguía, N. Esandi
Corresponding author
jhuetope@cfnavarra.es
Correspondencia: Sección de Neumología. Hospital Virgen del Camino. Irunlarrea, s/n. 31008 Pamplona (Navarra). España
Correspondencia: Sección de Neumología. Hospital Virgen del Camino. Irunlarrea, s/n. 31008 Pamplona (Navarra). España
Sección de Neumología. Hospital Virgen del Camino. Pamplona (Navarra). España
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"apellidos" => "Hueto" "email" => array:1 [ 0 => "jhuetope@cfnavarra.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Boldú" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Cebollero" ] 3 => array:2 [ "nombre" => "J.A." "apellidos" => "Cascante" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Abu-Shams" ] 5 => array:2 [ "nombre" => "V.M." "apellidos" => "Eguía" ] 6 => array:2 [ "nombre" => "N." "apellidos" => "Esandi" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Sección de Neumología. Hospital Virgen del Camino. Pamplona (Navarra). España" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Sección de Neumología. Hospital Virgen del Camino. Irunlarrea, s/n. 31008 Pamplona (Navarra). España" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Diagnosis and treatment of obstructive sleep apnea-hypopnea syndrome: the situation in Navarra (Spain)" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2002-06-10" "fechaAceptado" => "2002-10-15" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec190633" "palabras" => array:5 [ 0 => "Síndrome de apneas-hipopneas durante el sueño" 1 => "Diagnóstico" 2 => "Presión positiva continua sobre la vía aérea" 3 => "Cumplimiento" 4 => "Efectos secundarios" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec190634" "palabras" => array:5 [ 0 => "Sleep apnea-hypopnea syndrome" 1 => "Diagnosis" 2 => "Continuous positive airway pressure" 3 => "Compliance" 4 => "Side effects" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evaluar la situación del diagnóstico y tratamiento en el síndrome de apneas-hipopneas obstructivas durante el sueño (SAHS) y conocer algunas características de los pacientes tratados con presión nasal positiva continua en la vía aérea (n-CPAP) en nuestra comunidad.</p> <span class="elsevierStyleSectionTitle">Metodología</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se incluyó en el estudio a todos los pacientes que en julio de 2000 recibían tratamiento con n-CPAP a cargo del Servicio Navarro de Salud. Una enfermera realizó una visita a cada paciente en la que rellenaba un formulario con datos epidemiológicos, antropométricos y clínicos; posteriormente llevaba a cabo las siguientes exploraciones: medición del CO en el aire espirado, determinación de la presión de n-CPAP utilizada y lectura del contador horario de la n-CPAP. Entre uno y 2 meses después, y sin previo aviso, se ponía de nuevo en contacto con el usuario y se procedía a una segunda visita en la que realizaba una segunda determinación de CO en el aire espirado y nueva lectura del contador.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La tasa de prevalencia de tratamientos con n-CPAP en nuestra comunidad fue de 125 por 100.000 habitantes, y se comprobó un progresivo incremento de las prescripciones anuales. Se visitó en el domicilio a 535 pacientes (el 80,7% del total). El 83,5% de las indicaciones fueron realizadas por neumólogos; la media de horas/día reales de utilización de n-CPAP fue de 6,1 y existió una correlación estadísticamente significativa entre las horas de uso de n-CPAP declaradas y las reales; el índice de apneas-hipopneas (IAH) medio fue de 51,5 y este índice no se determinó en el 4,2% de los casos. Un 83,7% de los pacientes declaraban tener una tolerancia del tratamiento muy buena o buena y el 24,8% llevaba más de 4 años con esta terapia. La enfermedad asociada con el SAHS más frecuente fue la obesidad, presente en el 73,4% de las personas, seguida de la hipertensión arterial en el 40%; 299 enfermos (55,8%) padecían dos o más enfermedades asociadas y 54 (9,7%) no tenían ninguna. El 45,9% de los casos disponía de polisomnografía convencional como método diagnóstico y un 49,7% de poligrafía respiratoria; en el 19,4% la nivelación de la presión se realizó con polisomnografía y el 32,1% no disponía de ningún estudio para este fin. Un 50,8% de las personas referían presentar algún efecto secundario al tratamiento.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Elevada tasa de prevalencia de tratamientos con n-CPAP en Navarra y progresivo incremento de prescripciones. Buena tolerancia y cumplimiento de la terapia por parte de los pacientes. Disponibilidad en la mayoría de los casos de polisomnografía o poligrafía respiratoria como métodos diagnósticos de SAHS y alto porcentaje de titulaciones de n-CPAP sin haberse realizado los estudios recomendados.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To assess the diagnosis and treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS) in Navarra (Spain) and to know the characteristics of patients treated with nasal continuous positive airway pressure (n-CPAP) in our community.</p> <span class="elsevierStyleSectionTitle">Method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">All patients receiving nasal n-CPAP from the public health service of Navarra in July 2000 were enrolled. A nurse visited each patient and filled in a form with epide-miological data, and patient and clinical characteristics. The nurse then measured CO in expired air and the n-CPAP pressure used and recorded the hour counter reading on the n-CPAP device. Between one and two months later and without prior warning, the patient was once again contacted and a second visit was made. The counter was read again and expired CO was measured.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The prevalence of treatment with n-CPAP in Navarra was 125/100,000 inhabitants, and a gradual increase in annual prescriptions was observed. Home visits were made to 535 patients (80.7% of the total). Pneumologists wrote 83.5% of the prescriptions. n-CPAP was used a mean 6.1 hours/day, and the numbers of declared and real hours of use were statistically correlated. The mean apnea-hypopnea index was 51.5, although results were not available for 4.2% of the patients. The treatment was well tolerated according to 83.7% of the patients and 24.8% had been following it for over four years. The pathology most often associated with OSAHS was obesity (73.4% of the patients), followed by high blood pressure (40%); 299 patients (55.8%) had two or more associated diseases and 54 (9.7%) had none. Conventional polysomnography was the diagnostic method used in 45.9% of the cases, and respiratory polygraphs were available for 49.7%. Pressure was adjusted with the aid of polysomnography for 19.4% patients, whereas 32.1% had undergone no testing. Side effects of treatment were reported by 50.8%.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">a) The prevalence of n-CPAP treatment in Navarra is high and prescriptions are increasing; b) patient tolerance of and compliance with therapy are good, c) poly-somnographs or respiratory polygraphs are available for diagnosis of OSAHS in most cases but the n-CPAP pressure level is adjusted without the recommended studies for many patients.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:28 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sleep apnea syndromes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C. Guilleminault" 1 => "W.C. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 0 | 1 | 1 |
| 2024 October | 34 | 13 | 47 |
| 2024 September | 28 | 11 | 39 |
| 2024 August | 52 | 31 | 83 |
| 2024 July | 27 | 27 | 54 |
| 2024 June | 39 | 15 | 54 |
| 2024 May | 41 | 26 | 67 |
| 2024 April | 20 | 21 | 41 |
| 2024 March | 39 | 30 | 69 |
| 2024 February | 33 | 28 | 61 |
| 2024 January | 0 | 2 | 2 |
| 2023 December | 0 | 1 | 1 |
| 2023 November | 0 | 6 | 6 |
| 2023 October | 0 | 12 | 12 |
| 2023 September | 0 | 1 | 1 |
| 2023 August | 0 | 3 | 3 |
| 2023 July | 0 | 18 | 18 |
| 2023 June | 0 | 14 | 14 |
| 2023 March | 8 | 3 | 11 |
| 2023 February | 42 | 15 | 57 |
| 2023 January | 25 | 29 | 54 |
| 2022 December | 28 | 40 | 68 |
| 2022 November | 37 | 30 | 67 |
| 2022 October | 28 | 43 | 71 |
| 2022 September | 29 | 42 | 71 |
| 2022 August | 34 | 39 | 73 |
| 2022 July | 18 | 33 | 51 |
| 2022 June | 20 | 38 | 58 |
| 2022 May | 43 | 20 | 63 |
| 2022 April | 25 | 28 | 53 |
| 2022 March | 24 | 32 | 56 |
| 2022 February | 35 | 21 | 56 |
| 2022 January | 21 | 29 | 50 |
| 2021 December | 19 | 38 | 57 |
| 2021 November | 21 | 34 | 55 |
| 2021 October | 18 | 34 | 52 |
| 2021 September | 16 | 48 | 64 |
| 2021 August | 18 | 36 | 54 |
| 2021 July | 17 | 36 | 53 |
| 2021 June | 19 | 30 | 49 |
| 2021 May | 14 | 21 | 35 |
| 2021 April | 28 | 48 | 76 |
| 2021 March | 60 | 32 | 92 |
| 2021 February | 37 | 16 | 53 |
| 2021 January | 24 | 19 | 43 |
| 2020 December | 21 | 22 | 43 |
| 2020 November | 19 | 15 | 34 |
| 2020 October | 11 | 11 | 22 |
| 2020 September | 11 | 12 | 23 |
| 2020 August | 21 | 8 | 29 |
| 2020 July | 22 | 26 | 48 |
| 2020 June | 15 | 11 | 26 |
| 2020 May | 22 | 11 | 33 |
| 2020 April | 25 | 10 | 35 |
| 2020 March | 16 | 18 | 34 |
| 2020 February | 19 | 14 | 33 |
| 2020 January | 36 | 28 | 64 |
| 2019 December | 22 | 15 | 37 |
| 2019 November | 8 | 13 | 21 |
| 2019 October | 23 | 13 | 36 |
| 2019 September | 13 | 17 | 30 |
| 2019 August | 23 | 1 | 24 |
| 2019 July | 18 | 15 | 33 |
| 2019 June | 17 | 9 | 26 |
| 2019 May | 13 | 36 | 49 |
| 2019 April | 31 | 23 | 54 |
| 2019 March | 10 | 14 | 24 |
| 2019 February | 11 | 12 | 23 |
| 2019 January | 12 | 7 | 19 |
| 2018 December | 14 | 27 | 41 |
| 2018 November | 24 | 13 | 37 |
| 2018 October | 38 | 12 | 50 |
| 2018 September | 15 | 6 | 21 |
| 2018 May | 11 | 1 | 12 |
| 2018 April | 7 | 6 | 13 |
| 2018 March | 6 | 5 | 11 |
| 2018 February | 8 | 11 | 19 |
| 2018 January | 6 | 6 | 12 |
| 2017 December | 8 | 14 | 22 |
| 2017 November | 5 | 3 | 8 |
| 2017 October | 9 | 9 | 18 |
| 2017 September | 5 | 6 | 11 |
| 2017 August | 13 | 11 | 24 |
| 2017 July | 8 | 4 | 12 |
| 2017 June | 9 | 19 | 28 |
| 2017 May | 14 | 8 | 22 |
| 2017 April | 8 | 4 | 12 |
| 2017 March | 5 | 43 | 48 |
| 2017 February | 4 | 8 | 12 |
| 2017 January | 8 | 6 | 14 |
| 2016 December | 14 | 7 | 21 |
| 2016 November | 14 | 11 | 25 |
| 2016 October | 14 | 15 | 29 |
| 2016 September | 14 | 13 | 27 |
| 2016 August | 24 | 7 | 31 |
| 2016 July | 21 | 6 | 27 |
| 2016 June | 19 | 12 | 31 |
| 2016 May | 12 | 8 | 20 |
| 2016 April | 13 | 1 | 14 |
| 2016 March | 8 | 3 | 11 |
| 2016 February | 9 | 4 | 13 |
| 2016 January | 23 | 12 | 35 |
| 2015 December | 25 | 13 | 38 |
| 2015 November | 21 | 6 | 27 |
| 2015 October | 49 | 1 | 50 |
| 2015 September | 38 | 0 | 38 |
| 2015 August | 40 | 0 | 40 |
| 2015 July | 37 | 0 | 37 |
| 2015 June | 36 | 0 | 36 |
| 2015 May | 58 | 0 | 58 |
| 2015 April | 34 | 0 | 34 |
| 2015 March | 44 | 0 | 44 |
| 2015 February | 43 | 0 | 43 |
| 2015 January | 41 | 0 | 41 |
| 2014 December | 37 | 0 | 37 |
| 2014 November | 34 | 0 | 34 |
| 2014 October | 79 | 0 | 79 |
| 2014 September | 43 | 0 | 43 |
| 2014 August | 45 | 0 | 45 |
| 2014 July | 46 | 0 | 46 |
| 2014 June | 52 | 0 | 52 |
| 2014 May | 66 | 0 | 66 |
| 2014 April | 46 | 0 | 46 |
| 2014 March | 38 | 0 | 38 |
| 2014 February | 47 | 0 | 47 |
| 2014 January | 41 | 0 | 41 |
| 2013 December | 50 | 0 | 50 |
| 2013 November | 31 | 0 | 31 |
| 2013 October | 46 | 0 | 46 |
| 2013 September | 50 | 0 | 50 |
| 2013 August | 47 | 0 | 47 |
| 2013 July | 44 | 0 | 44 |
| 2013 June | 40 | 0 | 40 |
| 2013 May | 35 | 0 | 35 |
| 2013 April | 17 | 0 | 17 |
| 2013 March | 8 | 0 | 8 |
| 2000 January | 1260 | 0 | 1260 |
Show all
