[Argentine consensus on sleep-related respiratory disorders].
Due to the increased interest of the medical community in sleep disorders an experts meeting was called to establish common criteria for diagnosis, treatment and management of these disorders. Adult prevalence of sleep apnea/hypopnea syndrome (SA/HS) is about 2-4% and increases in the elderly. Snoring and excessive daytime somnolence (EDS) are habitual symptoms. Increased risk to cardiovascular disorders and traffic accidents are the major complications. Increased upper airways resistance syndrome is a recently described syndrome which also involves EDS. A standardized questionnaire was developed and its use was recommended in order to evaluate patients with respiratory sleep disorders (RSD). Polysomnography was established as gold standard in the diagnosis of RSD. Minimal requirement of split night studies and screening studies was also standardized and specific indications were summarized. Medical treatment of obesity in relationship to RSD was analyzed. Nasal continuous positive airways pressure (CPAP) was established as the first choice treatment of SA/HS. Titration of CPAP was standardized. Oral appliances with mandibular advancement could be considered in the treatment of snoring patients without SA/HS and in patients with increased upper airways resistance syndrome. Uvulopalatopharingoplasty can only be performed in snoring patients in whom the presence of SA/HS has been dismissed by polysomnography. Management of patients must include periodic clinical control. EDS must be determined by Epworth test. In order to evaluate CPAP compliance the use of time-controlled devices is highly recommended.
Sala
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Sección Insuficiencia Respiratoria y Trastornos del Sueño de la Asociación Argentina de Medicina Respiratoria y Asociación Argentina de Medicina del Sueño, Buenos Aires. hsala@janssen.com.ar
Nigro
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Rabec
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Guardia
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Smurra
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D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D010349:Patient Compliance; D011175:Positive-Pressure Respiration; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis / Q000628:therapy