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        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction and Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Sleep apnea-hypopnea syndrome is associated with an overall deterioration in the patient&#39;s health and affects between 1 and 2 million people in Spain&#46; The objective of the present study was to evaluate the diagnostic and therapeutic resources available in Spain for dealing with this problem in terms of both infrastructure and human resources&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">We selected 461 general hospitals&#44; 457 &#40;99&#46;1&#37;&#41; of which answered a questionnaire in the course of a telephone interview&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">At the time of response&#44; 219 hospitals &#40;47&#46;5&#37;&#41; reported performing sleep studies&#46; Conventional polysomnography was available in 53&#37; of those hospitals&#44; respiratory polygraphy was used in 42&#37;&#44; and oximetry in 5&#37;&#46; In 47&#37; of the hospitals&#44; continuous positive airway pressure was titrated empirically in most cases&#59; the number of patients being treated with CPAP was 109&#8200;752&#44; that is&#44; 269 per 100&#8200;000 population in Spain&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The level of resources available for diagnosing and treating sleep apnea-hypopnea syndrome&#44; although improving&#44; is clearly still inadequate&#46; Currently&#44; only 0&#46;49 polysomnograph and 0&#46;72 polygraph machines are available per 100&#8200;000 population&#44; whereas 1 and 3 machines&#44; respectively&#44; are deemed necessary&#46; Only 5&#37; to 10&#37; of the affected population has been diagnosed&#44; and in 47&#37; of the hospitals interviewed continuous positive airway pressure is not properly titrated&#46; These results should be a clarion call to the health authorities to take the appropriate steps to address this health problem&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n y Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">El s&#237;ndrome de apneas-hipopneas durante el sue&#241;o est&#225; asociado a un deterioro del estado de salud y constituye un problema sanitario que en Espa&#241;a sufren entre 1 y 2 millones de personas&#46; El objetivo del estudio fue evaluar cu&#225;les son los medios diagn&#243;sticos y terap&#233;uticos disponibles en Espa&#241;a&#44; tanto en infraestructu-ras como en recursos humanos&#44; para abordar este problema&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se seleccionaron 461 hospitales generales y me-diante contacto telef&#243;nico se administr&#243; un cuestionario a 457 &#40;99&#44;1&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Realizan estudios de sue&#241;o 219 centros &#40;47&#44;5&#37;&#41;&#46; El 53&#37; dispone de polisomnograf&#237;a convencional&#44; un 42&#37; emplea la poligraf&#237;a respiratoria y un 5&#37; la oximetr&#237;a&#46; Un 47&#37; de los centros realiza titulaciones de presi&#243;n positiva continua de la v&#237;a a&#233;rea de forma mayoritariamente emp&#237;rica y existen en activo 109&#46;752 aparatos&#44; lo que representa 269 equipos por 100&#46;000 habitantes&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">El nivel de recursos para el diagn&#243;stico y el tratamiento del s&#237;ndrome de apneas-hipopneas durante el sue&#241;o&#44; a pesar de haber mejorado&#44; es claramente insuficiente&#46; Son necesarios un polisomn&#243;grafo convencional y 3 pol&#237;-grafos&#44; mientras que actualmente se cuenta con 0&#44;49 y 0&#44;72 por 100&#46;000 habitantes&#44; respectivamente&#46; S&#243;lo se ha diagnos-ticado el 5-10&#37; de la poblaci&#243;n afectada y en el 47&#37; de los centros la presi&#243;n positiva continua de la v&#237;a a&#233;rea se titula de forma inadecuada&#46; Estos resultados deber&#237;an suponer una importante llamada de atenci&#243;n a las autoridades sanitarias para abordar apropiadamente este problema sanitario&#46;</p>"
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Vol. 40. Issue 6.
Pages 259-267 (June 2004)
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Vol. 40. Issue 6.
Pages 259-267 (June 2004)
Original Articles
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The Availability in Spanish Public Hospitals of Resources for Diagnosing and Treating Sleep Apnea-Hypopnea Syndrome
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3710
J. Durán-Cantollaa,
Corresponding author
joaquin.duran@wanadoo.es

Correspondence: Dr. J. Durán-Cantolla. Unidad Respiratoria de Trastornos del Sueño. Hospital Txagorritxu. José Achotegui, s/n. 01009 Vitoria. España
, J. Marb, G. de la Torre Muñecasa, R. Rubio Aramendia, L. Guerraa
a Unidad Respiratoria de Trastornos del Sueño, Hospital Txagorritxu, Vitoria, Spain
b Unidad de Gestión Sanitaria, Hospital Alto Deba, Mondragón, Guipúzcoa, Spain
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Introduction and Objective

Sleep apnea-hypopnea syndrome is associated with an overall deterioration in the patient's health and affects between 1 and 2 million people in Spain. The objective of the present study was to evaluate the diagnostic and therapeutic resources available in Spain for dealing with this problem in terms of both infrastructure and human resources.

Methods

We selected 461 general hospitals, 457 (99.1%) of which answered a questionnaire in the course of a telephone interview.

Results

At the time of response, 219 hospitals (47.5%) reported performing sleep studies. Conventional polysomnography was available in 53% of those hospitals, respiratory polygraphy was used in 42%, and oximetry in 5%. In 47% of the hospitals, continuous positive airway pressure was titrated empirically in most cases; the number of patients being treated with CPAP was 109 752, that is, 269 per 100 000 population in Spain.

Conclusions

The level of resources available for diagnosing and treating sleep apnea-hypopnea syndrome, although improving, is clearly still inadequate. Currently, only 0.49 polysomnograph and 0.72 polygraph machines are available per 100 000 population, whereas 1 and 3 machines, respectively, are deemed necessary. Only 5% to 10% of the affected population has been diagnosed, and in 47% of the hospitals interviewed continuous positive airway pressure is not properly titrated. These results should be a clarion call to the health authorities to take the appropriate steps to address this health problem.

Key words:
Sleep apnea-hypopnea syndrome (SAHS)
Continuous positive airway pressure (CPAP)
Diagnosis
Treatment
Conventional nocturnal polysomnography (PSG)
Respiratory polygraphy (RP)
General population
Patients
Introducción y Objetivo

El síndrome de apneas-hipopneas durante el sueño está asociado a un deterioro del estado de salud y constituye un problema sanitario que en España sufren entre 1 y 2 millones de personas. El objetivo del estudio fue evaluar cuáles son los medios diagnósticos y terapéuticos disponibles en España, tanto en infraestructu-ras como en recursos humanos, para abordar este problema.

Métodos

Se seleccionaron 461 hospitales generales y me-diante contacto telefónico se administró un cuestionario a 457 (99,1%).

Resultados

Realizan estudios de sueño 219 centros (47,5%). El 53% dispone de polisomnografía convencional, un 42% emplea la poligrafía respiratoria y un 5% la oximetría. Un 47% de los centros realiza titulaciones de presión positiva continua de la vía aérea de forma mayoritariamente empírica y existen en activo 109.752 aparatos, lo que representa 269 equipos por 100.000 habitantes.

Conclusions

El nivel de recursos para el diagnóstico y el tratamiento del síndrome de apneas-hipopneas durante el sueño, a pesar de haber mejorado, es claramente insuficiente. Son necesarios un polisomnógrafo convencional y 3 polí-grafos, mientras que actualmente se cuenta con 0,49 y 0,72 por 100.000 habitantes, respectivamente. Sólo se ha diagnos-ticado el 5-10% de la población afectada y en el 47% de los centros la presión positiva continua de la vía aérea se titula de forma inadecuada. Estos resultados deberían suponer una importante llamada de atención a las autoridades sanitarias para abordar apropiadamente este problema sanitario.

Palabras clave:
Síndrome de apneas-hipopneas durante el sueño (SAHS)
Presión positiva continua de la vía aérea (CPAP)
Diagnóstico
Tratamiento
Polisomnografía convencional nocturna
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