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Vol. 30. Issue 8.
Pages 390-393 (October 1994)
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Vol. 30. Issue 8.
Pages 390-393 (October 1994)
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Estudios polisomnográficos cortos en el diagnóstico del síndrome de apnea obstructiva del sueño
Shorter polysomnographs for diagnosis of obstructive sleep apnea syndrome
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C. Carmona Bernal*, F. Capote Gil, S. Cano Gómez, A. Sánchez Armengol, J.F. Medina Gallardo, J. Castillo Gómez
Servicio de Neumología. Hospital Universitario Virgen del Rocío. Sevilla
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El diagnóstico de certeza del síndrome de apnea obstructiva del sueño (SAOS) se realiza clásicamente con el registro polisomnográfíco de una noche entera, con el coste de tiempo que ello supone. Como alternativa se han propuesto estudios cortos de sueño. Se ha evaluado la eficacia del registro poligráfico de las tres primeras horas de sueño nocturno (EC) para el diagnóstico del SAOS y se han comparado los resultados con el registro de toda la noche (EN). Para ello se han estudiado 25 pacientes varones con sospecha clínica de SAOS, obteniéndose el diagnóstico en 19 con los EN y en 16 con los EC, lo que supone 3 falsos negativos, con una sensibilidad del 84% para los EC. No se obtuvo ningún falso positivo al analizar sólo las tres primeras horas de la noche, lo cual indica una especificidad del 100%. Se han encontrado diferencias significativas en la saturación de oxígeno (Sat02) mínima y en el porcentaje de tiempo total de sueño transcurrido en intervalos de SatO2, inferiores al 80%. Por lo tanto se puede concluir que el registro poligráfico de la primera parte del sueño nocturno es un método específico para el diagnóstico del SAOS y que, aunque su sensibilidad es alta, ante un registro negativo está indicado continuar el estudio durante toda la noche. Finalmente, la magnitud de las desaturaciones puede subestimarse en el registro de la primera mitad de la noche.

Firm diagnosis of obstructive sleep apnea syndrome (OSAS) is normally based on all-night-long polysomnograms, at considerable expenditure of time and money. Shorter studies have been proposed as an alternative. We have assessed the efficacy of polysomnograms recorded over the first three hours of nocturnal sleep (SN) for diagnosing OSAS and the results have been compared with those of polysomnograms recorded throughout the entire night (EN). Twenty-five male patients suspected of having OSAS were enrolled; 19 were diagnosed for OSAS by EN and 16 were diagnosed by SN, indicating 3 false negatives and a sensitivity of 84% for SS. No false positives were obtained by studying only the first three hours of sleep, indicating a specificity of 100%.

Significant differences were found in mínimum oxygen saturacion (SatO2) and percent of total sleep time with intervals of SatO, below 80%. We conclude that polysomnography during the first part of nocturnal sleep is a specific method for screening for OSAS and that, although this method's sensitivity is high, study should be continued throughout an entire night when results are negative. Desaturation levels may be underestimated in recordings lating only the first half of the night.

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Copyright © 1994. Sociedad Española de Neumología y Cirugía Torácica
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