Borsini Eduardo, Nogueira Facundo, Nigro Carlos
Hospital Británico de Buenos Aires.
Argentinian Group for Investigation and Study of Sleep Disorders (GAIAS).
Sleep Sci. 2018 Jan-Feb;11(1):45-48. doi: 10.5935/1984-0063.20180010.
According to recent reports, sleep disorders affect 30% of the adult population and 5-10% of children. Obstructive Sleep Apnea Hypopnea Syndrome (OSA) has a considerable epidemiological impact and demand for consultation is growing in our community. Therefore, it is necessary to know the principles of interpretation of diagnostic methods. A suspicion of OSA requires confirmation. According to the guidelines of the Argentine Association of Respiratory Medicine, polysomnography (PSG) is the gold standard for OSA diagnosis, while home sleep testing (HST) can be accepted as a comparatively effective method depending on the clinical situation of the patient. This article questions the use of AHI (apnea-hypopnea index) as the only measurement needed to diagnose OSA and assess its severity. In fact, it is surprising that, despite the large mass of data analyzed during sleep studies, current practices only focus on AHI. More than four decades have passed since OSA was first described. Our tendency to oversimplify complex conditions may prevent us from gaining a deeper and more thorough understanding of OSA. The development and validation of OSA severity scoring systems based on multiple parameters is still a pending issue.
根据最近的报告，睡眠障碍影响30%的成年人口和5 - 10%的儿童。阻塞性睡眠呼吸暂停低通气综合征（OSA）具有相当大的流行病学影响，并且在我们社区对咨询的需求正在增加。因此，有必要了解诊断方法的解读原则。对OSA的怀疑需要得到证实。根据阿根廷呼吸医学协会的指南，多导睡眠图（PSG）是OSA诊断的金标准，而家庭睡眠测试（HST）根据患者的临床情况可被视为一种相对有效的方法。本文质疑将呼吸暂停低通气指数（AHI）作为诊断OSA和评估其严重程度所需的唯一测量指标的使用。事实上，令人惊讶的是，尽管在睡眠研究中分析了大量数据，但目前的做法仅关注AHI。自首次描述OSA以来已经过去了四十多年。我们将复杂情况过度简化的倾向可能会阻止我们对OSA有更深入和全面的理解。基于多个参数的OSA严重程度评分系统的开发和验证仍然是一个悬而未决的问题。
