RESUMEN
Resumen El síndrome de apnea hipoapnea del sueño (SAHS), está asociado fuertemente a la obesidad. El objetivo de este estudio es determinar las variaciones en el índice de masa corporal (IMC) en pacientes portadores de SAHS luego de un año de tratamiento con CPAP. Resultados: 104 pacientes varones fueron incluidos en este estudio, las variables analizadas fueron: índice de apnea-hipopnea (IAH), índice de masa corporal (IMC) y cuestionario de somnolencia diurna Epworth. Respecto a los datos obtenidos de IMC, se encontró tras un año de tratamiento con CPAP un descenso significativo de esta variable (p < 0,001). En la escala de somnolencia también se obtuvo un descenso significativo. Discusión: La evidencia ha sugerido regularmente que a mayor peso corporal existirían también niveles más elevados de IAH, las mejoras en el IMC referidas en este estudio, resaltan la importancia del correcto tratamiento no solo en el control de los eventos respiratorios, sino que en la disminución del peso corporal.
Sleep Apnea Syndrome (SAS) it is highly related to obesity. The main purpose of this study is to determine the variation between Apnea Hypopnea Index (AHI) and Body Mass Index (BMI) on sleep apnea patients after a year of CPAP treatment on the Linde Sleep Center. Results: 104 male patients were included in this study, the variables analyzed were; AHI, BMI, Epworth daytime somnolence. As for the data obtained from BMI, after one year of treatment with CPAP, the BMI showed a significant decrease (p < 0.001). In the daytime sleepiness scale, a significant decrease was also found between pre and post treatment values. Discussion: Evidence has consistently suggested that higher body weight would also have higher levels of AHI, and the improvements in BMI referred to in this study emphasize the importance of proper treatment not only in control of respiratory events, but in the reduction of body weight.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Índice de Masa Corporal , Apnea Obstructiva del Sueño/terapia , Presión de las Vías Aéreas Positiva Contínua , Síndromes de la Apnea del Sueño/diagnóstico , Encuestas y Cuestionarios , Estudios RetrospectivosRESUMEN
BACKGROUND AND OBJECTIVE: Obstructive sleep apnoea (OSA) is associated with an increased risk of cardiovascular disease. Our objective was to evaluate subclinical atherosclerosis in OSA patients and the effect of continuous positive airway pressure (CPAP) treatment on carotid intima-media thickness (cIMT). PATIENTS AND METHOD: We included 125 patients with suspected OSA. After polysomnography, 107 patients were diagnosed with OSA; 58 of these met the criteria for CPAP treatment. cIMT was measured by ultrasonography at baseline in all patients and after 2 years of follow up in 50 patients on CPAP and 35 without CPAP treatment. RESULTS: The average cIMT was significantly thicker in OSA than in non-OSA patients (665±120 vs. 581±78µm, P=.005) and did not differ according to OSA severity. Atheromatous carotid plaque was more prevalent in OSA than non-OSA patients (48 vs. 2%, P=.004). Among OSA patients, the mean cIMT remained stable over time in the group without CPAP, whereas cIMT decreased markedly in the CPAP group (679±122 vs. 631±117µm, P<.0001). CONCLUSIONS: Increased cIMT was associated with presence of OSA, but not with its severity. Carotid ultrasound in OSA is a reliable marker of atherosclerosis. CPAP treatment with CPAP in OSA reduces cIMT and cardiovascular risk.
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Aterosclerosis/prevención & control , Presión de las Vías Aéreas Positiva Contínua , Apnea Obstructiva del Sueño/terapia , Adolescente , Adulto , Anciano , Aterosclerosis/diagnóstico por imagen , Aterosclerosis/etiología , Grosor Intima-Media Carotídeo , Estudios de Casos y Controles , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Apnea Obstructiva del Sueño/complicaciones , Resultado del Tratamiento , Adulto JovenRESUMEN
INTRODUCTION: The socioeconomic impact of obstructive sleep apnea-hypopnea syndrome (OSAHS) is considerable. The aim of this study was to evaluate the cost-effectiveness of treating OSAHS with continuous positive airway pressure (CPAP) and the impact of CPAP compliance. METHODS: This was a retrospective, case-crossover study of 373 patients with OSAHS receiving CPAP. We compared changes in costs, Epworth score and health-related quality of life (EQ-5D questionnaires) between the year before treatment and the year after treatment. The incremental cost-effectiveness ratio (ICER) for the first year of treatment was estimated, and projections were made for the second year, using different effectiveness and cost scenarios. RESULTS: The visual analog scale score for the EQ-5D questionnaire increased by 5 points and the Epworth score fell by 10 points during the year of CPAP treatment. Mean gain in quality-adjusted life years (QALY) was 0.05 per patient per year (P<.001): 0.07 among compliers and -0.04 among non-compliers. ICER was 51,147/QALY during the first year of CPAP treatment and 1,544/QALY during the second year. CONCLUSION: CPAP treatment in patients with moderate-severe OSAHS improves the quality of life of compliant patients, and is cost-effective as of the second year.
Asunto(s)
Presión de las Vías Aéreas Positiva Contínua , Apnea Obstructiva del Sueño/terapia , Anciano , Presión de las Vías Aéreas Positiva Contínua/economía , Costo de Enfermedad , Análisis Costo-Beneficio , Estudios Cruzados , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Cooperación del Paciente , Polisomnografía , Años de Vida Ajustados por Calidad de Vida , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Apnea Obstructiva del Sueño/economía , EspañaRESUMEN
INTRODUCTION: Studies on inflammation biomarkers in serum and in exhaled breath condensate (EBC) in obstructive sleep apnea (OSA) have shown conflicting results. The objective of this study is to assess EBC and serum biomarkers in OSA patients at baseline and after continuous positive airway pressure (CPAP) or upper airway surgery (UAS). PATIENTS AND METHODS: Nine OSA patients referred for UAS were matched for anthropometric characteristics and apnea-hypopnea index with 20 patients receiving CPAP. pH, nitrite (NO2(-)), nitrate and interleukin 6 in EBC and NO2(-), nitrate, leukotriene B4 and interleukin 6 in serum were determined. EBC and serum samples were collected at baseline and 3 months after CPAP or UAS. RESULTS: Patients' mean body mass index was 30 (range 24.9-40) kg/m(2). EBC biomarker levels at baseline were within normal range and did not differ significantly after CPAP or UAS. No significant changes were observed in the serum concentration of the biomarkers determined after CPAP but the serum concentration of NO2(-) increased significantly at 3 months after UAS (P=.0078). CONCLUSION: In mildly obese OSA patients, EBC biomarkers of inflammation or oxidative stress were normal at baseline and remained unchanged 3 months after UAS or CPAP. Although UAS was not effective in terms of reducing OSA severity, it was associated with an increase in serum NO2(-).