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Perspectivas de panel de expertos sobre pruebas de varias noches para la apnea obstructiva del sueño: Un estudio

Kai Fricke1, Philip Heesen1, Noriane A Sievi1

  • 1Faculty of Medicine, University of Zurich, Switzerland; Department of Pulmonology, University Hospital Zurich, Switzerland.

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Los estudios de sueño de varias noches pueden mejorar el diagnóstico de la apnea obstructiva del sueño (AOS) cuando los resultados son inciertos. Los expertos recomiendan un protocolo de tres noches y el uso del índice de apnea-hipopnea (IAH) promedio para las decisiones de tratamiento.

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índice de apnea-hipopneaconsenso Delphipruebas de varias nochesapnea obstructiva del sueño

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Área de la Ciencia:

  • Medicina del Sueño
  • Precisión Diagnóstica
  • Guías de Práctica Clínica

Sus antecedentes:

  • El diagnóstico de apnea obstructiva del sueño (AOS) se basa en estudios de sueño de una sola noche.
  • La variabilidad noche a noche en la AOS puede causar un diagnóstico erróneo y afectar el tratamiento.
  • El valor de las pruebas de sueño de varias noches en la AOS no está bien establecido.

Objetivo del estudio:

  • Establecer el consenso de expertos sobre el uso de pruebas de sueño de varias noches para el diagnóstico de AOS.
  • Definir indicaciones, momento, realización e interpretación de pruebas de AOS de varias noches.
  • Abordar el papel clínico de las pruebas de varias noches en el manejo de la AOS.

Principales métodos:

  • Un estudio Delphi modificado que involucra a 13 expertos internacionales en medicina del sueño.
  • Dos rondas de cuestionarios estructurados y retroalimentación anónima.
  • Consenso definido como acuerdo entre al menos el 70% de los expertos.

Principales resultados:

  • Consenso alcanzado sobre 12 de 17 declaraciones (71%).
  • Los expertos apoyan las pruebas de varias noches para la variabilidad sospechosa de AOS, IAH límite o hallazgos clínicos incongruentes.
  • Se respaldó un protocolo de tres noches y el IAH promedio para las decisiones de tratamiento.

Conclusiones:

  • Se apoya la prueba selectiva de varias noches para casos de AOS inciertos.
  • Un protocolo de tres noches y umbrales promedio de IAH ofrecen un enfoque práctico.
  • Se necesita más investigación para la estandarización y la integración en la práctica clínica.