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Apnea obstructiva del sueño en adultos Apnea obstructiva del sueño en adultos

Amy S Jordan1, David G McSharry2, Atul Malhotra3

  • 1University of Melbourne, Melbourne, VIC, Australia; Institute for Breathing and Sleep, Melbourne, VIC, Australia.

Lancet (London, England)
|August 6, 2013
PubMed
Resumen

La apnea obstructiva del sueño (AOS) es un trastorno del sueño común que causa colapso de las vías respiratorias y pérdida de oxígeno. La presión positiva continua en las vías respiratorias es el tratamiento principal, aunque existen otras opciones para aquellos intolerantes.

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Área de la Ciencia:

  • Medicina del sueño Medicina del sueño.
  • Medicina de las vías respiratorias Medicina de las vías respiratorias
  • Cardiología Cardiología.

Sus antecedentes:

  • La apnea obstructiva del sueño (AOS) es una condición prevalente caracterizada por el colapso recurrente de las vías respiratorias superiores durante el sueño.
  • Este colapso conduce a hipoxia intermitente y sueño fragmentado, presentándose con síntomas como ronquidos, apnea presenciada y somnolencia diurna.
  • La patogénesis es multifactorial, que involucra factores anatómicos, neurológicos y musculares, con la obesidad, el sexo masculino y el tabaquismo como factores de riesgo clave.

Objetivo del estudio:

  • Revisar la patogénesis, los factores de riesgo y las consecuencias clínicas de la apnea obstructiva del sueño.
  • Discutir las modalidades de tratamiento establecidas y alternativas para la AOS.
  • Para resaltar la asociación de la AOS con enfermedades cardiovasculares y metabólicas.

Principales métodos:

  • Revisión de la literatura sobre la apnea obstructiva del sueño.
  • Síntesis de información sobre la patogénesis, los factores de riesgo y el impacto clínico.
  • Visión general de las estrategias de tratamiento actuales, que incluyen presión positiva en las vías respiratorias, dispositivos dentales, cirugía y modificaciones en el estilo de vida.

Principales resultados:

  • La AOS está vinculada a una morbilidad significativa, incluida la somnolencia, el aumento del riesgo de accidentes y la probable hipertensión sistémica.
  • Se sugieren asociaciones con infarto de miocardio, insuficiencia cardíaca, accidente cerebrovascular y diabetes mellitus, pero se requieren más pruebas definitivas.
  • La presión positiva continua en las vías respiratorias (CPAP) demuestra una adherencia del 60-70%, con PAP de dos niveles y servo-ventilación adaptativa como alternativas.

Conclusiones:

  • La AOS es un trastorno común con graves implicaciones para la salud, que requiere un manejo eficaz.
  • La CPAP sigue siendo el tratamiento estándar de oro, pero la adherencia y la tolerancia del paciente son factores críticos.
  • Un enfoque multimodal, que incluya terapias alternativas y cambios en el estilo de vida, es esencial para la gestión efectiva de la AOS.