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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Los RERA &#40;<span class="elsevierStyleItalic">respiratory effort-related arousal</span>&#41; son secundarios a sutiles obstrucciones de la v&#237;a a&#233;rea superior durante el sue&#241;o&#44; pueden aparecer sin predominio de apneas e hipopneas y causan somnolencia diurna excesiva&#46; El an&#225;lisis de las potenciales consecuencias de estos nuevos acontecimientos respiratorios tiene hoy un inter&#233;s creciente&#46; Los conductores habitualmente somnolientos tienen un riesgo alto de sufrir accidentes de tr&#225;fico asociados a trastornos respiratorios durante el sue&#241;o &#40;apneas m&#225;s hipopneas m&#225;s RERA&#41;</p> <span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este trabajo es determinar si exclusivamente el exceso de RERA es un factor independiente de riesgo de accidentes en los conductores somnolientos</p> <span class="elsevierStyleSectionTitle">M&#233;todo</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudiamos a 40 conductores habitualmente somnolientos y 23 controles &#40;conductores no somnolientos&#41; pareados por edad y sexo&#44; y ambos extra&#237;dos de una muestra de 4&#46;002 conductores de veh&#237;culos&#46; Se estudiaron datos sobre h&#225;bitos de sue&#241;o&#44; somnolencia diurna&#44; accidentes de tr&#225;fico y se realizaron estudios de sue&#241;o con medida de presi&#243;n esof&#225;gica</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los conductores somnolientos con apneas de sue&#241;o tienen una tasa de accidentes en 5 a&#241;os mayor que los controles &#40;&#237;ndice de apneas-hipoapneas &#91;IAH&#93; &#62; 10&#59; 0&#44;33<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;50 frente a 0&#44;004<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;21 en los controles&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#44; pero s&#243;lo el exceso de RERA y no el de apneas de sue&#241;o fue un factor independiente de riesgo de accidentes en conductores somnolientos&#46; La odds ratio&#40;OR&#41; ajustada para un &#237;ndice de RERA<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10 fue de 7&#44;6 &#40;intervalo de confianza &#91;IC&#93; del 95&#37;&#44; 1&#44;2&#8211;48&#41; y para un &#237;ndice de RERA<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15 fue de 17 &#40;IC&#44; 1&#44;5&#8211;91&#41;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El alto riesgo de accidentes de tr&#225;fico de los conductores somnolientos viene principalmente determinado por la presencia de RERA m&#225;s que por la presencia de apneas e hipopneas de sue&#241;o&#46; Estos datos ratifican la importancia y la necesidad de identificar RERA en la pr&#225;ctica habitual de los laboratorios de sue&#241;o</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Respiratory effortrelated arousals &#40;RERA&#41; are secondary to subtle obstructions of the upper airway during sleep and can appear in the absence of a predominance of apneas and hypopneas&#44; causing excessive daytime sleepiness&#46; Analyzing the possible consequences of these new respiratory events is of increasing interest&#46; Habitually sleepy drivers are at high risk of having traffic accidents related to sleep disorders &#40;apneas&#44; hypopneas and RERA&#41;</p> <span class="elsevierStyleSectionTitle">Objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to determine whether excess RERA alone is an independent risk factor among sleepy drivers</p> <span class="elsevierStyleSectionTitle">Method</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">We studied 40 habitually sleepy drivers and 23 age- and sex-matched controls selected from a sample of 4&#44;002 automobile drivers&#46; We surveyed sleep habits&#44; daytime sleepiness and traffic accidents&#46; Sleep studies of esophageal pressure were performed</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The sleepy drivers with apneas &#40;apnea&#47;hypopnea index &#62; 10&#41; had a higher 5-year accident rate &#40;0&#46;33<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;50&#41; than did control drivers &#40;0&#46;004<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;21&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; However&#44; a high RERA index&#44; but not sleep apnea&#44; was an independent risk factor among the habitually sleepy drivers&#46; The adjusted odds ratio &#40;OR&#41; for a RERA index<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10 was 7&#46;6 &#40;confidence interval &#91;CI&#93;&#44; 1&#46;2 to 48&#41;&#59; for a RERA index<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#44; the OR was 17 &#40;CI 1&#46;5 to 91&#41;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">The high risk of traffic accidents among sleepy drivers is mainly determined by the presence of RERA rather than the presence of apneas and hypopneas&#46; These findings verify the importance of identifying RERA in routine sleep laboratory studies</p>"
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Vol. 39. Issue 4.
Pages 153-158 (April 2003)
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Vol. 39. Issue 4.
Pages 153-158 (April 2003)
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Los conductores somnolientos tienen alta frecuencia de accidentes de tráfico asociados a exceso de RERA
Sleepy drivers have a high frequency of traffic accidents related to respiratory effort-related arousals
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9389
J.F. Masa Jiméneza,
Corresponding author
fmasa@separ.es

Correspondencia: Rafael Alberti, 12. 10005 Cáceres. España
, M. Rubio Gonzálezb, L.J. Findleyc, J.A. Riesco Mirandaa, A. Sojo Gonzáleza, C. Disdier Vicentea
a Sección de Neumología. Hospital San Pedro de Alcántara. Cáceres
b Centro de Salud San Jorge. Cáceres. España
c Sleep Disorders Center. Loveland (Colorado). EE.UU
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Abstract
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Introducción

Los RERA (respiratory effort-related arousal) son secundarios a sutiles obstrucciones de la vía aérea superior durante el sueño, pueden aparecer sin predominio de apneas e hipopneas y causan somnolencia diurna excesiva. El análisis de las potenciales consecuencias de estos nuevos acontecimientos respiratorios tiene hoy un interés creciente. Los conductores habitualmente somnolientos tienen un riesgo alto de sufrir accidentes de tráfico asociados a trastornos respiratorios durante el sueño (apneas más hipopneas más RERA)

Objetivo

El objetivo de este trabajo es determinar si exclusivamente el exceso de RERA es un factor independiente de riesgo de accidentes en los conductores somnolientos

Método

Estudiamos a 40 conductores habitualmente somnolientos y 23 controles (conductores no somnolientos) pareados por edad y sexo, y ambos extraídos de una muestra de 4.002 conductores de vehículos. Se estudiaron datos sobre hábitos de sueño, somnolencia diurna, accidentes de tráfico y se realizaron estudios de sueño con medida de presión esofágica

Resultados

Los conductores somnolientos con apneas de sueño tienen una tasa de accidentes en 5 años mayor que los controles (índice de apneas-hipoapneas [IAH] > 10; 0,33±0,50 frente a 0,004±0,21 en los controles; p<0,05), pero sólo el exceso de RERA y no el de apneas de sueño fue un factor independiente de riesgo de accidentes en conductores somnolientos. La odds ratio(OR) ajustada para un índice de RERA=10 fue de 7,6 (intervalo de confianza [IC] del 95%, 1,2–48) y para un índice de RERA=15 fue de 17 (IC, 1,5–91)

Conclusiones

El alto riesgo de accidentes de tráfico de los conductores somnolientos viene principalmente determinado por la presencia de RERA más que por la presencia de apneas e hipopneas de sueño. Estos datos ratifican la importancia y la necesidad de identificar RERA en la práctica habitual de los laboratorios de sueño

Palabras clave:
Rera (respiratory effort related arousal)
Apneas de sueño
Síndrome de resistencia aumentada de la vía aérea superior
Accidentes de tráfico
Introduction

Respiratory effortrelated arousals (RERA) are secondary to subtle obstructions of the upper airway during sleep and can appear in the absence of a predominance of apneas and hypopneas, causing excessive daytime sleepiness. Analyzing the possible consequences of these new respiratory events is of increasing interest. Habitually sleepy drivers are at high risk of having traffic accidents related to sleep disorders (apneas, hypopneas and RERA)

Objective

The aim of this study was to determine whether excess RERA alone is an independent risk factor among sleepy drivers

Method

We studied 40 habitually sleepy drivers and 23 age- and sex-matched controls selected from a sample of 4,002 automobile drivers. We surveyed sleep habits, daytime sleepiness and traffic accidents. Sleep studies of esophageal pressure were performed

Results

The sleepy drivers with apneas (apnea/hypopnea index > 10) had a higher 5-year accident rate (0.33±0.50) than did control drivers (0.004±0.21; p<0.05). However, a high RERA index, but not sleep apnea, was an independent risk factor among the habitually sleepy drivers. The adjusted odds ratio (OR) for a RERA index=10 was 7.6 (confidence interval [CI], 1.2 to 48); for a RERA index=15, the OR was 17 (CI 1.5 to 91)

Conclusions

The high risk of traffic accidents among sleepy drivers is mainly determined by the presence of RERA rather than the presence of apneas and hypopneas. These findings verify the importance of identifying RERA in routine sleep laboratory studies

Keywords:
Respiratory effort-related arousal (RERA)
Sleep apnea
Increased upper airway resistance syndrome
Automobile accidents
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Copyright © 2003. Sociedad Española de Neumología y Cirugía Torácica
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