Diagnóstico y tratamiento del síndrome de apnea obstructiva del sueño en adultos mayores, diciembre 2018 - enero 2019

Abstract

Introduction: OSAS is a pathology with the appearance of nocturnal and diurnal symptoms, with a Gold diagnostic method standard (polysomnography) and therapeutic with CPAP. Objectives: To determine the diagnosis and treatment accessible to the public salary, by means of the review of scientific articles where the personnel of primary and specialized attention can capture greater universe, to diminish the risks of morbidity and mortality. Materials and methods: Through a database of PubMed, Cochrane, Elsevier, Scielo, Redalic, among others, scientific articles were compiled, mostly meta-analyzes, published in indexed journals, during the period 2015-2016. Results: With several meta-analyzes, two of them were included, where four questionnaires were compared; Berlin, STOP-BANG, STOP and Epworth, the first meta-analysis included 39 studies with 18,068 subjects with mild OSA sensitivity from 81.08% to 97.55%, and severe from 69.2% to 98.7%, the second meta-analysis included 108 studies with 47,989 participants whose sensitivity for a mild OSA in 76%, 88%, 87% and 54%; for the moderate 77%, 90%, 89% and 47% and for the severe in 84%, 93%, 90% and 58%, respectively. A meta-analysis included 8 studies of 502 subjects determined that physical activity and training reduced the rate of apnea-hypopnea (mean decrease of 8.9 events / h, 95% CI, p <0.01). Modafinil has a greater beneficial effect (p = 0.0001) than intranasal mometasone furoate. Conclusion: Primary care staff should use STOB-BANG for early diagnosis, and implement physical activity and modafinil to better resolve this pathological entity.