RESUMEN
In polysomnography, RERA is defined as a respiratory parameter that indicates an arousal associated with a respiratory event and an increase in respiratory effort. Initially, RERA was described by means of esophageal manometry for the evaluation of respiratory effort. This greater respiratory effort occurs as a response to an increase in upper airway resistance, which is a factor present in the pathophysiology of sleep-disordered breathing, such as obstructive sleep apnea syndrome and upper airway resistance syndrome. Later, the use of a nasal pressure cannula was reported to be a reliable means of identifying airflow limitation and one that is more sensitive than is a thermistor. In addition, the nasal pressure cannula method has been used as a surrogate for esophageal manometry in the identification of periods in which upper airway resistance increases. Consequently, the American Academy of Sleep Medicine recommend the use of either method for the identification of RERA, which is defined by the flattening of the inspiratory curve, characteristic of airflow limitation. Although RERA has been identified and evaluated in current medical practice, it has yet to be standardized. Therefore, it is recommended that polysomnographic reports indicate which abnormal respiratory events were taken into consideration in the evaluation of the severity of sleep-disordered breathing.
Asunto(s)
Síndromes de la Apnea del Sueño/diagnóstico , Trastornos del Despertar del Sueño/diagnóstico , Resistencia de las Vías Respiratorias/fisiología , Humanos , Manometría/métodos , Polisomnografía/métodos , Síndromes de la Apnea del Sueño/fisiopatología , Síndromes de la Apnea del Sueño/terapia , Trastornos del Despertar del Sueño/etiología , Trastornos del Despertar del Sueño/terapiaRESUMEN
Na polissonografia, RERA é definido como um parâmetro respiratório que indica um despertar associado a um evento respiratório e um aumento do esforço respiratório. Inicialmente, RERA foi descrito com o uso da manometria esofágica utilizada para avaliação do esforço respiratório. Esse maior esforço respiratório ocorre como resposta a um aumento da resistência da via aérea superior, aspecto presente na fisiopatologia dos distúrbios respiratórios do sono, entre esses, SAOS e SRVAS. Posteriormente, o uso de cânula de pressão nasal foi relatado como uma maneira confiável e mais sensível que o termistor para a identificação de eventos de redução do fluxo aéreo e também como um substituto da manometria esofágica para a identificação de períodos de aumento da resistência na via aérea superior. Consequentemente, a American Academy of Sleep Medicine recomenda o uso de um dos métodos para a identificação de RERA, que é definido por um padrão de achatamento da curva inspiratória, característico da limitação ao fluxo aéreo. Embora RERA seja identificado e avaliado na pratica médica, sua padronização ainda é necessária. Portanto, recomenda-se que os laudos de polissonografia indiquem quais eventos respiratórios anormais foram considerados na avaliação do grau de gravidade do distúrbio respiratório.
In polysomnography, RERA is defined as a respiratory parameter that indicates an arousal associated with a respiratory event and an increase in respiratory effort. Initially, RERA was described by means of esophageal manometry for the evaluation of respiratory effort. This greater respiratory effort occurs as a response to an increase in upper airway resistance, which is a factor present in the pathophysiology of sleep-disordered breathing, such as obstructive sleep apnea syndrome and upper airway resistance syndrome. Later, the use of a nasal pressure cannula was reported to be a reliable means of identifying airflow limitation and one that is more sensitive than is a thermistor. In addition, the nasal pressure cannula method has been used as a surrogate for esophageal manometry in the identification of periods in which upper airway resistance increases. Consequently, the American Academy of Sleep Medicine recommend the use of either method for the identification of RERA, which is defined by the flattening of the inspiratory curve, characteristic of airflow limitation. Although RERA has been identified and evaluated in current medical practice, it has yet to be standardized. Therefore, it is recommended that polysomnographic reports indicate which abnormal respiratory events were taken into consideration in the evaluation of the severity of sleep-disordered breathing.