Multidisciplinaridade na apneia do sono: uma revisão de literatura

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Abstract

Síndrome da Apneia/Hipopneia Obstrutiva do sono (SAHOS) é uma doença crônica, evolutiva que pode ocasionar graves repercussões comportamentais, cardiovasculares e neurológicos ao paciente.O objetivo deste estudo é realizar uma revisão sistematizada sobre a importância da abordagem multidisciplinar no diagnóstico e tratamento da Síndrome da Apneia e Hipopnéia Obstrutiva do sono. Vários profissionais da área de saúde podem atuar no diagnóstico e tratamento desta síndrome, destacando-se atuação dos médicos, dentistas, fisioterapeutas e fonoaudiólogos.

Translated abstract

Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS) is a chronic and progressive disease, which can cause serious behavioral, cardiovascular and neurological repercussions to the patient. This study is aimed to conduct a systematic review about the importance of the multidisciplinary approach to diagnosis and treatment of Obstructive Sleep Apnea/Hypopnea Syndrome. Several healthcare professionals can work in the diagnosis and treatment of this syndrome, but the emphasis is given to doctors, dentists, physiotherapists and speech therapists actions.

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Most cited references 35

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Practice parameters for the indications for polysomnography and related procedures: an update for 2005.

Clete Kushida, Michael Littner, Timothy Morgenthaler … (2005)

These practice parameters are an update of the previously-published recommendations regarding the indications for polysomnography and related procedures in the diagnosis of sleep disorders. Diagnostic categories include the following: sleep related breathing disorders, other respiratory disorders, narcolepsy, parasomnias, sleep related seizure disorders, restless legs syndrome, periodic limb movement sleep disorder, depression with insomnia, and circadian rhythm sleep disorders. Polysomnography is routinely indicated for the diagnosis of sleep related breathing disorders; for continuous positive airway pressure (CPAP) titration in patients with sleep related breathing disorders; for the assessment of treatment results in some cases; with a multiple sleep latency test in the evaluation of suspected narcolepsy; in evaluating sleep related behaviors that are violent or otherwise potentially injurious to the patient or others; and in certain atypical or unusual parasomnias. Polysomnography may be indicated in patients with neuromuscular disorders and sleep related symptoms; to assist in the diagnosis of paroxysmal arousals or other sleep disruptions thought to be seizure related; in a presumed parasomnia or sleep related seizure disorder that does not respond to conventional therapy; or when there is a strong clinical suspicion of periodic limb movement sleep disorder. Polysomnography is not routinely indicated to diagnose chronic lung disease; in cases of typical, uncomplicated, and noninjurious parasomnias when the diagnosis is clearly delineated; for patients with seizures who have no specific complaints consistent with a sleep disorder; to diagnose or treat restless legs syndrome; for the diagnosis of circadian rhythm sleep disorders; or to establish a diagnosis of depression.

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Epidemiology of pediatric obstructive sleep apnea.

Julie Lumeng, Ronald Chervin (2008)

Pediatric obstructive sleep apnea (OSA) has become widely recognized only in the last few decades as a likely cause of significant morbidity among children. Many of the clinical characteristics of pediatric OSA, and the determinants of its epidemiology, differ from those of adult OSA. We systematically reviewed studies on the epidemiology of conditions considered part of a pediatric sleep-disordered breathing (SDB) continuum, ranging from primary snoring to OSA. We highlight a number of methodologic challenges, including widely variable methodologies for collection of questionnaire data about symptomatology, definitions of habitual snoring, criteria for advancing to further diagnostic testing, and objective diagnostic criteria for SDB or OSA. In the face of these limitations, estimated population prevalences are as follows: parent-reported "always" snoring, 1.5 to 6%; parent-reported apneic events during sleep, 0.2 to 4%; SDB by varying constellations of parent-reported symptoms on questionnaire, 4 to 11%; OSA diagnosed by varying criteria on diagnostic studies, 1 to 4%. Overall prevalence of parent-reported snoring by any definition in meta-analysis was 7.45% (95% confidence interval, 5.75-9.61). A reasonable preponderance of evidence now suggests that SDB is more common among boys than girls, and among children who are heavier than others, with emerging data to suggest a higher prevalence among African Americans. Less convincing data exist to prove differences in prevalence based on age. We conclude by outlining specific future research needs in the epidemiology of pediatric SDB.

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Adult obstructive sleep apnea: pathophysiology and diagnosis.

Vijay Patil, Hartmut Schneider, J. Smith … (2007)

Obstructive sleep apnea (OSA) is a highly prevalent disease characterized by recurrent episodes of upper airway obstruction that result in recurrent arousals and episodic oxyhemoglobin desaturations during sleep. Significant clinical consequences of the disorder cover a wide spectrum, including daytime hypersomnolence, neurocognitive dysfunction, cardiovascular disease, metabolic dysfunction, and cor pulmonale. The major risk factors for the disorder include obesity, male gender, and age. Current understanding of the pathophysiologic basis of the disorder suggests that a balance of anatomically imposed mechanical loads and compensatory neuromuscular responses are important in maintaining upper airway patency during sleep. OSA develops in the presence of both elevated mechanical loads on the upper airway and defects in compensatory neuromuscular responses. A sleep history and physical examination is important in identification of patients and appropriate referral for polysomnography. Understanding nuances in the spectrum of presenting complaints and polysomnography correlates are important for diagnostic and therapeutic approaches. Knowledge of common patterns of OSA may help to identify patients and guide therapy.

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Author and article information

Contributors

Ayonara Dayane Leal da Silva: Role: ND

Maria Helena Chaves de Vasconcelos Catão: Role: ND

Roniery de Oliveira Costa: Role: ND

Ivna Rafaela Ribeiro dos Santos Costa: Role: ND

Journal

Journal ID (publisher): rcefac

Title: Revista CEFAC

Abbreviated Title: Rev. CEFAC

Publisher: CEFAC Saúde e Educação (São Paulo )

ISSN: 1982-0216

Publication date (Print): October 2014

Volume: 16

Issue: 5

Pages: 1621-1626

Affiliations

[1 ] Universidade Estadual da Paraíba Brazil

[2 ] Universidade Estadual da Paraíba Brazil

[3 ] Universidade Estadual da Paraíba Brazil

[4 ] Universidade Estadual Vale do Acaraú Brazil

Article

Publisher ID: S1516-18462014000501621

DOI: 10.1590/1982-021620143713

SO-VID: d89c040d-9c5e-40c6-89a3-3ad2a1c6137b

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http://creativecommons.org/licenses/by/4.0/

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SciELO Brazil

Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1516-1846&lng=en

Multidisciplinaridade na apneia do sono: uma revisão de literatura Translated title: Multidisciplinary in sleep apnea: a literature review

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Abstract

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Most cited references 35

Practice parameters for the indications for polysomnography and related procedures: an update for 2005.

Epidemiology of pediatric obstructive sleep apnea.

Adult obstructive sleep apnea: pathophysiology and diagnosis.

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