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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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Bibliografía
[1.]
J.M. Marin, J.R. Kimoff, M.G. Cosío.
Síndrome de apnea obstructiva del sueño y su tratamiento mediante presión positiva aérea nasal continua.
Arch Bronconeumol, 26 (1990), pp. 255-261
[2.]
A. Williams, S. Santiago, M. Stein.
Screening for sleep apnea?.
Chest, 96 (1989), pp. 451-453
[3.]
J.H. Peter.
Sleep Apnea and Cardiovascular Diseases.
Obstructive Sleep Apnea Syndrome: Clinical Research and Treatment, pp. 81-98
[4.]
J.W. Shepard.
Hypertension, cardiac arrhythmias, myocardial infarction and stroke in relation to obstructive sleep apnea.
Clin Chest Med, 13 (1992), pp. 437-458
[5.]
L.J. Findley, M.P. Levinson, R.J. Bonnie.
Driving performance and automobile accidents in patients with sleep apnea.
Clin Chest Med, 13 (1992), pp. 427-435
[6.]
W.W. Schmidt, P. Jenum.
Epidemiology of Sleep Apnea.
Obstructive Sleep Apnea Syndrome: Clinical Research and Treatment, pp. 1-8
[7.]
C.E. Sullivan, F.G. Issa.
Obstructive sleep apnea.
Clin Chest Med, 6 (1985), pp. 633-650
[8.]
F. Series, Y. Cormier, J. La Forge.
Validity of Diurnal Sleep Recording in the Diagnosis of Sleep Apnea Syndrome.
Am Rev Respir Dis, 143 (1991), pp. 947-949
[9.]
S.M. Scharf, E. Garshick, R. Brown, P.V. Tishler, T. Tosteson, R. McCarley.
Screening for Subclinical Sleep-Disorders Breathing.
Sleep, 13 (1990), pp. 344-353
[10.]
C. Guilleminault, M. Partinen, T. Penzel, G. Amend, K. Meinzer, J.H. Peter, et al.
Technical Issues Related to Obstructive Sleep Apnea Syndrome.
Obstructive Sleep Apnea Syndrome. Clinical Research and Treatment, pp. 183-207
[11.]
G. Aubert-Tulkens, C. Culée, K. Harmant-Van Rijckevorsel, O. Rodenstein.
Ambulatory Evaluation of Sleep Disturbance and Therapeutic Effects in Sleep Apnea Syndrome by Wrist Activity Monitoring.
Am Rev Respir Dis, 136 (1987), pp. 851-856
[12.]
T. Penzel, G. Amend, K. Meinzer, J.H. Peter, P. von Wichert.
MESAM: A Heart Rate and Snoring Recorder for Detection of Obstructive Sleep Apnea.
Sleep, 13 (1990), pp. 175-182
[13.]
American Thoracic Society.
Indications and standards for cardiopulmonary sleep studies.
Am Rev Respir Dis, 139 (1989), pp. 559-568
[14.]
A. White Funsten, P.M. Suratt.
Evaluation of Rcspiratory Disorders During Sleep.
Clin Chest Med, 10 (1989), pp. 265-275
[15.]
C.J. Roberts, R.G. Hooper.
Prcdiction of polysomnography results by abbreviated testing.
Chest, 88 (1985), pp. 43
[16.]
Goode Gb, H.M. Slyter.
Daytime polysomonogram diagnosis of sleep disorders.
J Neurol Neurosurg Psychiatry, 49 (1983), pp. 159-161
[17.]
R. Silvestri, C. Guilleminault, R. Coleman, T. Roth, W.C. Dement.
Nocturnal sleep versus nap findings in patients with breathing abnormalities during sleep.
Sleep res, 11 (1982), pp. 174A
[18.]
P. Haraldsson, C. Carenfelt, E. Knutsson, H.E. Persson, J. Rinder, Preliminary Report:.
Validity of Symptom Analysis and Daytime Polysomnography in Diagnosis of Sleep Apnea.
Sleep, 15 (1992), pp. 261-263
[19.]
H. Biernacka, N.J. Douglas.
Evaluation of a computerised polysomnography System.
Thorax, 48 (1993), pp. 280-283
[20.]
A manual of standarized terminology, techniques and scoring Systems for sleep stages of human subjects,
[21.]
M.H. Sanders, J. Black, J.P. Costantino, N. Kern, K. Studnicki, J. Coates.
Diagnosis of Sleep-Disordered Breathing by HalfNight Polysomnography.
Am Rev Respir Dis, 144 (1991), pp. 1.256-1.261
[22.]
B.A. Phillips, J. Okeson, D. Paesani, R. Gilmore.
Effect of sleep position on sleep apnea and parafuncional activity.
Chest, 90 (1986), pp. 424-429
[23.]
F. Sériés, Y. Cormier, J. La Forge.
Influence of Apnea Type and Sleep Stage on Nocturnal Postapneic Desaturation.
Am Rev Respir Dis, 141 (1990), pp. 1.522-1.526
[24.]
N.J. Douglas.
Control of ventilation during sleep.
Principies and Practice of Sleep Medicine, pp. 249-256
[25.]
C. Iber, C. O’Brien, J. Schuter, S. Davies, J. Leatherman, M. Mahowald.
Single Night Studies in Obstructive Sleep Apnea.
Sleep, 14 (1991), pp. 383-385
[26.]
M.H. Sanders, N.B. Kern, J.P. Costantino, R.A. Stiller, K. Studnicki, J. Coates, et al.
Adequacy of Prescribing Positive Airway Pressure Therapy by Mask for Sleep Apnea on the Basis of a PartialNight Trial.
Am Rev Dis-, 147 (1993), pp. 1.169-1.174
Copyright © 1994. Sociedad Española de Neumología y Cirugía Torácica
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