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Salud

«SAOS»: usted podría tener este importante trastorno del sueño”

Por Fernando Andrés Schifferli Salazar / 29 de abril de 2021

Descuidar nuestra salud durante las horas de sueño pude traer graves consecuencias.

Uno de los principales pero poco conocidos trastornos del sueño, se denomina Síndrome de Apnea del Sueño (SAOS). Este síndrome, es considerado en la Clasificación Internacional de los Trastornos del Sueño como una «disomnia intrínsica», junto a otras disfunciones, tales como: el Insomnio psicofisiológico; la Narcolepsia; la Hipersomnia recurrente; el Movimientos periódicos de extremidades; Síndrome de Apnea Cenrtral del Sueño (SACS) y el Síndrome de piernas inquietas.

Es el trastorno respiratorio del sueño más importante. Se caracteriza por episodios transitorios pero repetidos de obstrucción vía aérea superior: totales (apneas) o parciales (hipoapneas). Las apneas son períodos de ausencia de flujo de 10 segundos o más, mientras que las hipoapneas son fases de disminución del flujo seguidas de una desaturación o un «arousal».

El diagnóstico de SAOS se suele realizar, en un paciente con síntomas sugestivos o cuando el índice de apnea-hipopnea (IAH = número de apneas e hipopnea por hora de sueño) es igual o superior a 5.

FACTORES PREDISPONENTES PARA EL DESARROLLO DEL SINDROME DE APNEA OBSTRUCTIVA DEL SUEÑO
Obstrucción de la vía aérea superior

  • Desviación septum nasal.
  • Hipertrofia adenoides.
  • Hipertrofia amigdalar.
  • Hipertrofia úvula.
  • Hipertrofia velopalatina.
  • Hipertrofia base lengua.

Alteraciones maxilofaciales

  • Retrognatia.
  • Micrognatia.

Trastornos médicos generales

  • Obesidad.
  • Hipotiroidismo.
  • Acromegalia.
  • Síndrome de Cushing.
  • Síndrome de Down.
    ¿Cómo se diagnostica el SAOS?
    La tríada sintomática clásica consiste en: Ronquidos
    Apneas
    Somnolencia excesiva durante el día.

Si lo desea, puede llenar el siguiente cuestionario (*Cuestionario Stop-Bang) para detectar su riesgo de SAOS con mayor precisión:
Responda a las siguientes preguntas (Sí o No) para determinar si puede estar en riesgo:

¿Ronca? ¿Ronca fuerte (lo suficientemente fuerte como para ser escuchado a través de puertas cerradas o su compañero (a) le señala que le molesta su ronquido?

¿Cansancio? ¿Se siente frecuentemente con cansancio, fatiga o con sueño diurno (por ejemplo, con tendencia a dormirse mientras conduce o habla con alguien?

¿Observado (a)? ¿Alguien le ha observado que deja de respirar o se ahoga /jadea durante el sueño?

¿Presión?¿Tiene o recibe tratamiento para la hipertensión arterial?

¿Indice de masa corporal superior a 35 kg/m2? Calcular Índice de Masa Corporal :Peso (Kg) / altura (m2)

¿Edad mayor de 50 años?

¿Tamaño del cuello grande? (Medido alrededor de la manzana Adams o de «Adan») ¿El cuello de su camisa mide 40 cm o más o el cuello de su camisa es de 40cm o más?

¿Sexo Masculino ?

Análisis de resultados para la población general:
SAOS – Riesgo bajo: Sí a 0 – 2 preguntas.
SAOS – Riesgo intermedio: Sí a 3 – 4
preguntas.
SAOS – Riesgo alto: Sí a 5 – 8 preguntas.
o Sí a 2 o más de 4 preguntas STOP + sexo masculino.
o Sí a 2 o más de 4 preguntas STOP + IMC > 35kg/m2.
o Sí a 2 o más de 4 preguntas STOP + perímetro del cuello es de 40cm.

  • Propiedad de University Health Network.©

El SAOS PUEDE SER UN FACTOR IMPORTANTE PARA POTENCIAR EL RIESGO Y/O AUMENTAR lA INCIDENCIA DE LAS SIGUIENTES PATOLOGÍAS:

Alteraciones oximétricas y/o de la ventilación pulmonar.
Alteraciones nutricionales (obesidad).
Alteraciones endocrinas (Diabetes Mellitus 2 y/o resistencia a la insulina).
Alteraciones hemodinámicas (Hipertensión arterial, infartos cardíacos (IAM o SCA), infartos cerebrales (ACV o AVE).
Alteraciones psicológicas por fragmentación del sueño (mal dormir).

DATOS ESTADÍSTICOS A TENER EN CUENTA:
Los roncadores con somnolencia diurna tienen riesgo elevado de tener un accidente laboral (Lindberg E, Carter N, Gislason T, Janson C. Role of snoring and daytime sleepiness in occupational accidents. Am J Respir Crit Care Med. 2001;164(11):2031-5. 8).

El riesgo accidentes automovilísticos en conductores particulares somnolientos aumenta 8 veces. (Connor J, Norton R, Ameratunga S, Robinson, Civil I,Dunn R, et al. Driver sleepiness and risk of serious injury to occupants: population based case control study. BMJ 2002;324(5):1125-8).

La somnolencia, puede ser un factor categórico en 36 % de los accidentes automovilísticos fatales y en 42 a 54 % de todos los accidentes registrados (NEJM; Volume 340:847-851 March 18, 1999 Number 11).

El 6.3% de los casos, son sujetos mayores de 30 años (NEJM).

Sólo un pequeño porcentaje está diagnosticado, ya que los trastornos respiratorios del sueño pasan desapercibidos clínicamente con frecuencia (NEJM).

NOTA: para mayor información y asistencia médica al respecto, le aconsejamos el siguiente link, en formato QR: https://dormir.cl/prensa/

Por: Fernando Andrés Schifferli Salazar
f.schifferli@panalmedia.cl

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