Evaluación de la somnolencia diurna excesiva en conductores profesionales con sospecha de síndrome de apnea obstructiva durante el sueño

Pathway for the Management of Sleep Apnea in the Cardiac Patient

Sleep-disordered breathing is a highly prevalent medical condition, which if undiagnosed leads to increased morbidity and mortality, particularly related to increased incidence of cardiovascular events. It is therefore imperative that we identify patient population at high risk for sleep apnea and refer them to the appropriate therapy as early as possible. Up-to-date there is no management guideline specifically geared towards cardiac patients. Thus, we propose a (SAP) Sleep Apnea Pathway to correctly identify and triage these patients to the appropriate therapy.

Hypersomnolence and Traffic Safety

Many people die or become disabled because of motor vehicle accidents. Scientific data suggest that sleepy drivers or those driving at odd hours are more likely to make driving mistakes. Patients with obstructive sleep apnea and narcolepsy have been found to exhibit higher rates of falling asleep while driving. Treatment enhances the vigilance of these drivers. Tests measuring the extent of daytime sleepiness or drowsiness while driving can help identify at-risk drivers. There is a need to develop clear regulations governing periodic assessment of drivers' risks of falling asleep at the wheel, especially commercial drivers.

Evaluación clínica del paciente con roncopatía

INTRODUCTION

Sleep disordered breathing patients usually undergo an ENT clinical examination before any therapeutic decision is taker. This clinical examination should be predictive about the occurrence of OSAS, reproductible and should determine the sites of obstruction in the upper airways. We have evaluated the clinical ENT examination and compared it with the bibliography in order to standardize it.

MATERIALS AND METHODS

We have done the same clinical ENT examination to 181 patients. 127 had a standar polysomnography.

RESULTS

The patient's mean age was 49.6 years, the mean BMI was 29.3 kg/m2. 92.7% had an abnormal palate, 4.5% a tonsilar hipertrophy, 66.5% high Modified Mallampati scores, 60.8% were clasiffied as Fujita IIb type and 39.2% had nasal obstruction.

CONCLUSIONS

Upper airway examination is important for the assessment of chronic snoring patients. Most of them have anatomical alterations that can be represented in visual scales to make it more reproductible. The obstruction area does not predict the severity of OSAS.