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Escala de Sueño para la Práctica General - La "GPSS" - Una propuesta de nueva herramienta para el uso en la práctica

Timothy Howarth¹, Joe Hedger², Winnie Chen³

¹Darwin Respiratory and Sleep Health, Darwin Private Hospital, Darwin, Northern Territory, Australia; Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.

|November 29, 2024

Abstracto

Antecedentes:

Este estudio piloto investigó una nueva herramienta simplificada de cribado de la SAOS que podría utilizarse en entornos de atención primaria o medicina general —la herramienta «GPSS», «General Practice Sleep Scale» (Escala de Sueño para la Práctica General)— y la comparó con las herramientas de cribado de SAOS comúnmente existentes.

MéTodos:

Se incluyó una muestra de conveniencia de pacientes que asistieron a la clínica de sueño y respiratoria del Territorio del Norte de Australia, siempre que completaran el GPSS antes de someterse a una polisomnografía diagnóstica. El GPSS constaba de 9 preguntas para proporcionar información sobre: sexo, edad, índice de masa corporal, circunferencia del cuello, ronquidos, apneas presenciadas, cansancio matutino, somnolencia diurna y presencia de hipertensión/diabetes/cardiopatía/depresión. La presencia de SAHS se definió como un índice de apnea-hipopnea ≥15/hora. La puntuación del GPSS se desarrolló mediante los logaritmos de las probabilidades (log odds) de las predicciones de regresión para cada pregunta del GPSS respecto a la SAHS.

Resultados:

Se inscribieron 159 pacientes (65 % hombres, mediana de edad de 45 años). Se asignó una puntuación mínima de 1 a las preguntas del GPSS, hasta un máximo de 5 para el predictor más fuerte (circunferencia del cuello). La mediana de la puntuación total del GPSS fue de 13 (IQR 9, 16) (máximo 22) y se correlacionó fuertemente con la OSA (AUC 0,812 (IC del 95 % 0,744, 0,881)). Al categorizarse en riesgo bajo (0-7), moderado (8-13) o alto (>13), una puntuación moderada o grave presentó una sensibilidad del 100 % y una especificidad del 34,9 %. El GPSS superó significativamente a la Escala de Somnolencia de Epworth, al cuestionario de Berlín y al OSA-50, y fue comparable, aunque ligeramente superior, al STOP-Bang.

Conclusiones:

La herramienta GPSS propuesta podría ser útil en entornos de medicina general. Se requiere de más investigación prospectiva para evaluar la aplicabilidad y adaptabilidad de la herramienta GPSS en entornos poblacionales más amplios.

Palabras clave:

Herramientas clínicas Diagnóstico Diferencial Evaluación de resultados Gestión de la práctica profesional Evaluación de riesgos Trastornos del sueño

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