ABSTRACT

Obstructive sleep apnea syndrome is a disorder characterized by repetitive events of total or partial obstruction of the pharynx present during sleep; It is a public health problem due to the complications it generates and the large number of people affected. Polysomnography as a standard of reference for diagnosis is expensive and unavailable, so it has not resolved the need for a massive diagnosis for obstructive sleep apnea syndrome; for this reason, respiratory polygraphy has emerged as a useful, valid and accessible diagnostic alternative. There are different types of polygraphs but the most common are those that define respiratory events using the signals of respiratory flow, effort and pulse oximetry. The objective of this document is to describe the scoring rules for respiratory polygraphs based on the flow and/or effort signals (with no sleep stages and arousals evaluation) for the diagnosis of obstructive sleep apnea syndrome in adults, according to the 2.6 version of American Academy of Sleep Medicine Manual for the Scoring of Sleep and Associated Events.

KEYWORDS

Obstructive sleep apnea, diagnosis, respiratory polygraphy.

REFERENCES

1. American Academy of Sleep Medicine. International classification of sleep disorders. 3a. ed. Darien, IL: American Academy of Sleep Medicine; 2014.

2. Carrillo-Alduenda JL, Arredondo-del Bosque FM, Reyes-Zúñiga M, et al. Síndrome de apnea obstructiva del sueño en población adulta. Neumol Cir Torax 2010;69(2):103-115.

3. Benjafield AV, Ayas NT, Eastwood PR, et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med 2019;7(8):687-698. https://doi.org/10.1016/s2213-2600(19)30198-5

4. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet 2017;390(10113):2627-2642. https://doi.org/10.1016/s0140-6736(17)32129-3

5. Organización de las Naciones Unidas, Departamento de Economía y Asuntos Sociales, División de Población (2017). World Population Ageing 2017: Highlights (ST/ESA/SER.A/397) [Fecha de consulta: 28 de agosto, 2019]. Accesible en: https://www.un.org/en/development/desa/population/theme/ageing/WPA2017.asp

6. Torre-Bouscoulet L, Castorena-Maldonado A. Pros y contras de la simplificación de los métodos diagnósticos en adultos con apnea obstructiva del sueño. Rev Inst Nal Enf Resp Mex 2008;21(2):131-141.

7. Ferber R, Millman R, Coppola M, et al. Portable recording in the assessment of obstructive sleep apnea. ASDA standards of practice. Sleep 1994;17(4):378-392. https://doi.org/10.1093/sleep/17.4.378

8. Drager LF. New challenges for sleep apnea research: Simple diagnostic tools, biomarkers, new treatments and precision medicine. Sleep Sci 2017;10(1):55-56. https://doi.org/10.5935/1984-0063.20170009

9. Collop NA, Anderson WM, Boehlecke B, et al. Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 2007;3(7):737-747.

10. Berry RB, Quan SF, Abreu AR, et al; for the American Academy of Sleep Medicine. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, Version 2.6. Darien, IL: American Academy of Sleep Medicine; 2020.

11. Vázquez JC, Tsai WH, Flemons WW, et al. Automated analysis of digital oximetry in the diagnosis of obstructive sleep apnoea. Thorax 2000;55(4):302-307. https://doi.org/10.1136/thorax.55.4.302

12. Cho JH, Kim HJ. Validation of ApneaLink™ Plus for the diagnosis of sleep apnea. Sleep Breath 2017;21(3):799-807. https://doi.org/10.1007/s11325-017-1532-3

13. Hernández-Bendezú MDC, Arias-Peña MY, Torres-Fraga MG, Carrillo-Alduenda JL. Quality of an ambulatory monitoring technique for diagnosing obstructive sleep apnea under conditions of limited resources. Sleep Sci 2018;11(4):269-273. https://doi.org/10.5935/1984-0063.20180042

14. Punjabi NM, Aurora RN, Patil SP. Home sleep testing for obstructive sleep apnea. Chest 2013;143(2):291-294. https://doi.org/10.1378/chest.12-2699