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European Respiratory Journal 02/2013; 41(2):257-258. · 5.89 Impact Factor
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European Respiratory Journal 10/2012; 40(4):1046-8. · 5.89 Impact Factor
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Ferran Barbé,
Joaquín Durán-Cantolla,
Manuel Sánchez-de-la-Torre,
Montserrat Martínez-Alonso,
Carmen Carmona,
Antonia Barceló,
Eusebi Chiner,
Juan F Masa,
Mónica Gonzalez,
Jose M Marín,
Francisco Garcia-Rio,
Josefa Diaz de Atauri,
Joaquín Terán,
Mercedes Mayos,
Mónica de la Peña,
Carmen Monasterio,
Felix del Campo,
Josep M Montserrat
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ABSTRACT: Continuous positive airway pressure (CPAP) is the first-line treatment for patients with symptomatic obstructive sleep apnea (OSA). However, its indication for all patients with sleep-disordered breathing, regardless of daytime symptoms, is unclear.
To evaluate the effect of CPAP treatment on the incidence of hypertension or cardiovascular events in a cohort of nonsleepy patients with OSA.
Multicenter, parallel-group, randomized controlled trial in 14 teaching hospitals in Spain. Between May 2004 and May 2006, 725 consecutive patients were enrolled who had an apnea-hypopnea index of 20 h(-1) or greater and an Epworth Sleepiness Scale score of 10 or less (scores range from 0-24, with values <10 suggesting no daytime sleepiness). Exclusion criteria were previous cardiovascular event, physical or psychological incapacity, chronic disease, or drug or alcohol addiction. Follow-up ended in May 2009.
Patients were allocated to receive CPAP treatment or no active intervention. All participants received dietary counseling and sleep hygiene advice.
Incidence of either systemic hypertension (taking antihypertensive medication or blood pressure greater than 140/90 mm Hg) or cardiovascular event (nonfatal myocardial infarction, nonfatal stroke, transient ischemic attack, hospitalization for unstable angina or arrhythmia, heart failure, or cardiovascular death).
Seven hundred twenty-three patients underwent follow-up for a median of 4 (interquartile range, 2.7-4.4) years (1 patient from each group did not receive allocated treatment); 357 in the CPAP group and 366 in the control group were included in the analysis. In the CPAP group there were 68 patients with new hypertension and 28 cardiovascular events (17 unstable angina or arrhythmia, 3 nonfatal stroke, 3 heart failure, 2 nonfatal myocardial infarction, 2 transient ischemic attack, 1 cardiovascular death). In the control group there were 79 patients with new hypertension and 31 cardiovascular events (11 unstable angina or arrhythmia, 8 nonfatal myocardial infarction, 5 transient ischemic attack, 5 heart failure, 2 nonfatal stroke). The hypertension or cardiovascular event incidence density rate was 9.20 per 100 person-years (95% CI, 7.36-11.04) in the CPAP group and 11.02 per 100 person-years (95% CI, 8.96-13.08) in the control group. The incidence density ratio was 0.83 (95% CI, 0.63-1.1; P = .20).
In patients with OSA without daytime sleepiness, the prescription of CPAP compared with usual care did not result in a statistically significant reduction in the incidence of hypertension or cardiovascular events. However, the study may have had limited power to detect a significant difference.
clinicaltrials.gov Identifier: NCT00127348.
JAMA The Journal of the American Medical Association 05/2012; 307(20):2161-8. · 30.03 Impact Factor
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Manuel Sánchez-de-la-Torre,
Olga Mediano,
Antonia Barceló,
Javier Piérola,
Monica de la Peña,
Cristina Esquinas,
Angelina Miro,
Joaquin Durán-Cantolla,
Alvar G Agustí,
Francisco Capote,
Jose Maria Marin,
Josep Maria Montserrat,
Francisco García-Río, Ferran Barbé
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ABSTRACT: Obstructive sleep apnea syndrome (OSAS) is a common disorder characterized by excessive daytime sleepiness and repetitive upper airway obstruction episodes during sleep. Clinically, obesity is a major risk factor for developing OSAS. However, OSAS has been associated with hormonal and metabolic alterations that could predispose patients to obesity. The aim of this study was to investigate the independent role of apneas and obesity on plasma levels of metabolic hormones (adiponectin, ghrelin, and leptin) in patients with OSAS.
We have studied patients with OSAS and controls with and without obesity. All patients were male, had an apnea-hypopnea index of 20/h or greater, and were eligible for nasal continuous positive airway pressure (nCPAP) treatment. Patients were considered obese (n = 28) when their BMI was higher than 30 kg/m(2) and non-obese (n = 21) when it was lower than 27 kg/m(2). Non-obese control subjects (n = 20) were non-snorers with a normal cardiorespiratory sleep study, while obese control subjects (n = 10) were recruited from those obese subjects who were visited in our sleep unit and for whom OSAS was excluded by full polysomnography. A single blood sample was obtained from an antecubital vein in all participants after the completion of the nocturnal sleep laboratory recording. Plasma leptin, adiponectin, and ghrelin levels were determined by radioimmunoassay.
The adiponectin, ghrelin, and leptin plasma levels were similar in both patients and controls. There were differences in leptin and adiponectin plasma levels between the obese and non-obese in both patient and control groups. In the case of ghrelin, differences between obese and non-obese subjects were only seen in patients. There were no significant differences in hormone levels between the obese controls and obese patients or between non-obese controls and non-obese patients. After 3 months of nCPAP treatment, adiponectin levels decreased significantly both in obese and non-obese patients, and leptin levels decreased in obese patients. Finally, nCPAP did not reduce ghrelin in either obese or non-obese patients.
The basal levels of leptin, adiponectin, and ghrelin were mostly associated with obesity. We found that sleep apnea was not a determinant factor in leptin, adiponectin, and ghrelin hormonal levels. Interestingly, nCPAP treatment diminishes leptin in obese OSA patients and adiponectin levels in obese and non-obese patients with OSAS.
Sleep And Breathing 09/2011; 16(3):649-56. · 1.84 Impact Factor
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Manuel Sánchez-de-la-Torre,
Javier Pierola,
Carme Vidal,
Antonia Barceló,
Mónica de la Peña,
Zahid Hussain,
Francisco Capote,
Joaquín Durán,
Alvar G N Agustí,
Luis de Lecea,
Gerard Torres,
Cristina Esquinas,
Montserrat Martinez, Ferran Barbé
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ABSTRACT: Obstructive sleep apnea syndrome (OSAS) is a complex disease with a strong genetic basis. One of the primary molecular domains affected by OSAS is sympathetic activity. Neuropeptide S (NPS) plays an important role in the regulation of the sleep-wakefulness cycle, anxiety states, and daytime sleepiness. It is important to study neuropeptides related to sympathetic activity regulation and how their function could be modified by genetic variants affecting the expression of these molecules.
We investigated the association of the non-synonymous polymorphism rs4751440 in the NPS precursor gene with OSAS and certain variables related to OSAS (daytime sleepiness, body mass index (BMI), insulin resistance, and blood pressure). This polymorphism causes an amino acid substitution in exon 3 of the human NPS precursor gene.
We included 253 OSAS patients and 70 healthy subjects. Genotyping was done by polymerase chain reaction using specific flanking primers and agarose gel electrophoresis. Daytime sleepiness, BMI, plasma levels of high-density lipoprotein, glucose, total cholesterol, insulin, triglycerides, and the homeostasis model assessment index were also determined.
A similar genotypic and allelic distribution was found in OSAS patients and controls. The risk of OSAS was not associated with the rs4751440 polymorphism. There was no significant interaction between daytime sleepiness or metabolic variables and the rs4751440 polymorphism.
Genotypic and allelic frequency distribution of the rs4751440 polymorphism was similar in OSAS patients and controls. In this population-based study, we could not show a significant association between rs4751440 polymorphism and susceptibility to OSAS or certain phenotypes related to OSAS (daytime sleepiness, BMI, systolic blood pressure, and insulin resistance) with the exception of diastolic blood pressure.
Sleep And Breathing 09/2011; 15(3):403-8. · 1.84 Impact Factor
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ABSTRACT: Obstructive Sleep Apnoea (OSA) is associated with increased oxidative stress. NADPH oxidases are the main source of Reactive Oxygen Species (ROS) in the vasculature. Several polymorphisms related to NADPH oxidase expression or activity have been identified. We compared the distribution of the allelic frequencies of A-930G and C242T polymorphisms and their possible relationship with the levels of 8-isoprostanes as a marker of oxidative stress in patients with OSA and in a control group without OSA.
This is a case-control study. We determined the A-930G and C242T p22phox genotypes in 427 patients with OSA and in 139 healthy subjects recruited from the Sleep Unit of Son Dureta University Hospital, (Palma de Mallorca, Spain). 8-Isoprostane was measured as an oxidative stress marker.
The distribution of the p22phox genotypes in OSA and in control subjects was different. The risk of OSA was associated with the presence of the G allele in the A-930G p22phox independently of age, gender, Body Mass Index (BMI), hypertension, dyslipemia and diabetes, but no association was found with the C242T polymorphism. The median level of 8-isoprostane was significantly higher in OSA patients. Synergic effect in 8-Isoprostane levels was observed when these two polymorphisms were analysed together.
the A-930G polymorphism of the p22phox gene may play an important role in genetic susceptibility to OSA. Furthermore, the C242T and A-930G polymorphisms of the p22phox gene have a synergic effect on the 8-isoprostane levels, suggesting that they may be involved in the development of oxidative stress in these patients.
Respiratory medicine 08/2011; 105(11):1748-54. · 2.33 Impact Factor
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Sleep 01/2011; 34(7):821; author reply 823, 825. · 5.05 Impact Factor
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Archivos de Bronconeumología 01/2011; 47(1):1-2. · 2.17 Impact Factor
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Miguel Carrera,
José M Marín,
Antonio Antón,
Eusebi Chiner,
Maria L Alonso,
Juan F Masa,
Ramón Marrades,
Ernest Sala,
Santiago Carrizo,
Jordi Giner,
Elia Gomez-Merino,
Joaquin Teran,
Carlos Disdier,
Alvar G N Agustí, Ferran Barbé
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ABSTRACT: This prospective, multicenter, double-blind, placebo-controlled study tested the hypothesis that noninvasive positive pressure ventilation reduces the need for endotracheal intubation in patients hospitalized in a pulmonary ward because of acute exacerbation of chronic obstructive pulmonary disease.
Seventy-five consecutive patients with exacerbation (pH, 7.31 +/- 0.02; Pao(2), 45 +/- 9 mm Hg; Paco(2), 69 +/- 13 mm Hg) were randomly assigned to receive noninvasive ventilation or sham noninvasive ventilation during the first 3 days of hospitalization on top of standard medical treatment.
The need for intubation (according to predefined criteria) was lower in the noninvasive ventilation group (13.5% vs 34%, P < .01); in 31 patients with pH not exceeding 7.30, these percentages were 22% and 77%, respectively (P < .001). Arterial pH and Paco(2) improved in both groups, but changes were enhanced by noninvasive ventilation. Length of stay was lower in the noninvasive ventilation group (10 +/- 5 vs 12 +/- 6 days, P = .06). In-hospital mortality was similar in both groups.
These results demonstrate that noninvasive positive pressure ventilation, in a pulmonary ward, reduces the need for endotracheal intubation, particularly in the more severe patients, and leads to a faster recovery in patients with acute exacerbation of chronic obstructive pulmonary disease.
Journal of critical care 02/2009; 24(3):473.e7-14. · 2.13 Impact Factor
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ABSTRACT: Sleep apnea-hypopnea syndrome (SAHS) is a highly prevalent disease in the general population and, due to its social and health repercussions, has become a major public health problem. The definition of this syndrome, as well as that of respiratory event, have been refined. The role of inflammatory mechanisms in the development of cardiovascular disease is currently under investigation and biological markers will probably be added, both in the definition of SAHS and in the choice of treatment. Although the gold standard in diagnosis is polysomnography, respiratory polygraphy has become a valid and complementary alternative, since this technique is a simplified method that can be performed in the home to confirm or exclude this disease. Expert systems such as single-channel devices may help to simplify diagnosis. Currently, the mainstay of treatment is still continuous positive airway pressure (CPAP); this modality is mainly indicated in patients with moderate or severe SAHS and has been shown to reduce mortality in this group.
Archivos de Bronconeumología 01/2009; 45 Suppl 3:14-21. · 2.17 Impact Factor
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ABSTRACT: The aim of this study was to compare the clinical, anthropometric, and polysomnographic characteristics of a broad group of patients with sleep apnea-hypopnea syndrome according to sex.
The study, conducted in 6 Spanish university hospitals, included consecutive patients attended from 2003 through 2005 with an apnea-hypopnea index greater than 5. Groups were formed according to sex and then stratified into age subgroups of younger (< or = 45 years) and older patients (> 45 years) for further comparison.
The study included 2464 men and 424 women. Women were older (mean [SD] age, 56 [12] years vs 51 [12] years), weighed more (body mass index, 31 [6] kg/m(2) vs 30 [5] kg/m2), and had a larger hip circumference (119 [15] cm vs 111 [12] cm) and smaller neck circumference (38 [3] cm vs 42 [9] cm) than men (P< .001 in all cases). The degree of daytime sleepiness (Epworth scale) and the apnea-hypopnea index were similar in both groups, although women had a longer sleep latency (23 [28] minutes vs 27 [32] minutes; P< .004) and a higher mean oxygen saturation (92% [4%] vs 91% [5%]) and minimum oxygen saturation (78% [11%] vs 75% [12%]; P< .0001) than men. On stratification by age, only weight differences between men and women were observed in the younger group whereas the older group also showed differences in oxygen saturation during sleep.
Women with sleep apnea-hypopnea are more overweight than men and tend to seek medical attention at an older age. The clinical and polysomnographic variables were generally similar for men and womenthe only differences were that sleep latency was longer and hypoxemia during sleep was more accentuated in women.
Archivos de Bronconeumología 12/2008; 44(12):685-8. · 2.17 Impact Factor
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Nuria Roure,
Silvia Gomez,
Olga Mediano,
Joaquin Duran,
Monica de la Peña,
Francisco Capote,
Joaquin Teran,
Juan Fernando Masa,
Maria Luz Alonso,
Jaime Corral,
Angeles Sánchez-Armengod,
Cristina Martinez,
Antonia Barceló,
David Gozal,
Jose Maria Marín, Ferran Barbé
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ABSTRACT: Excessive daytime sleepiness (EDS) is the major complaint in subjects with obstructive sleep apnea syndrome (OSAS). However, EDS is not universally present in all patients with OSAS. The mechanisms explaining why some patients with OSAS complain of EDS whereas others do not are unknown.
To investigate polysomnographic determinants of excessive daytime sleepiness (EDS) in a large multicenter cohort of patients with obstructive sleep apnea (OSAS).
All consecutive patients with an apnea-hypopnea index greater than 5h(-1) who were evaluated between 2003 and 2005. EDS was assessed using the Epworth Sleepiness Scale (ESS), and patients were considered to have EDS if the ESS was >10.
A total of 1649 patients with EDS ((mean [+/-SD] Epworth 15+/-3) and 1233 without EDS (Epworth 7+/-3) were studied. Patients with EDS were slightly younger than patients without EDS (51+/-12 vs 54+/-13 years, p<0.0001), had longer total sleep time (p<0.007), shorter sleep latency (p<0001), greater sleep efficiency (p<0.0001) and less NREM sleep in stages 1 and 2 (p<0.007) than those without EDS. Furthermore, patients with EDS had slightly higher AHI (p<0.005) and arousal index (p<0.001) and lower nadir oxygen saturation (p<0.01).
Patients with OSAS and EDS are characterized by longer sleep duration and increased slow wave sleep compared to those without EDS. Although patients with EDS showed a mild worsening of respiratory disturbance and sleep fragmentation, these results suggest that sleep apnea and sleep disruption are not the primary determinants of EDS in all of these patients.
Sleep Medicine 05/2008; 9(7):727-31. · 3.40 Impact Factor
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ABSTRACT: Excessive daytime sleepiness (EDS) is one of the most frequent symptoms in patients with obstructive sleep apnea syndrome (OSAS). However, not all patients with OSAS manifest EDS. The aim of this study was to assess whether differential circulatory levels of inflammatory mediators would account for differences in somnolence among patients with OSAS. Patients were prospectively recruited from referral patient cohort to the university hospital sleep center. A total of 50 consecutive patients with OSAS undergoing overnight polysomnography with or without EDS and 20 controls were evaluated. EDS was assessed using the Epworth sleepiness scale (ESS) and the multiple sleep latency test after overnight polysomnography. EDS was defined when the ESS was >10 and the mean sleep latency <10 min. Fasting blood was drawn in the morning after polysomnography. Circulating levels of tumor necrosis factor alpha (TNFalpha), interleukin-6 (IL-6), intercellular adhesion molecule 1 (ICAM-1), 8-isoprostaglandin F2alpha (8-iso-PGF2alpha), and P-selectin were measured with commercially available high sensitivity kits. Although patients with OSAS have elevated levels of ICAM-1, IL-6, and TNFalpha, there were no statistically significant differences in any of the inflammatory mediators between patients with EDS and without EDS. Emergence of EDS in the context of OSA does not appear to result from the selective increase of any particular somnogenic substance, i.e., TNFalpha, IL-6, ICAM-1, 8-iso-PGF2alpha, and P-selectin in the context of sleep-disordered breathing.
Sleep And Breathing 10/2007; 11(3):177-85. · 1.84 Impact Factor
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ABSTRACT: Continuous positive airway pressure (CPAP) reduces daytime somnolence in the obstructive sleep apnea syndrome (OSAS) and may contribute to a reduction in the risk of motor vehicle accidents.
To evaluate the effects of CPAP on automobile collisions in patients with OSAS.
We compared the number of motor vehicle accidents in 80 patients with OSAS and 80 healthy subjects during the 2 years before and the 2 years after study entry, at which CPAP treatment was initiated.
Patients with OSAS had a 2.6 times higher risk of suffering an automobile collision compared to controls (rate ratio, RR=2.57; 95% confidence interval, CI=1.30-5.05). After 2 years of CPAP treatment, the rate of collisions was reduced more than half in patients with OSAS (RR=0.41; 95% CI=0.21-0.79), but this occurred also in controls (RR=0.49; 95% CI=0.17-1.40). The magnitude of this fall between groups was not different (p for interaction=0.68), even after adjusting for body mass index, alcohol intake and Epworth scale.
Patients with OSAS have an increased risk of suffering a traffic collision. This risk was significantly reduced after their inclusion in the study. Yet, as this reduction also occurred in the control group, this effect may not be due to CPAP therapy.
Respiration 02/2007; 74(1):44-9. · 2.26 Impact Factor
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ABSTRACT: Excessive daytime sleepiness (EDS) is a major consequence of sleep-disordered breathing (SDB) in adults. In snoring children, spontaneous and respiratory arousals display reciprocal interactions, allowing for development of a new quantitative measure, the sleep pressure score (SPS), which provides intra-polysomnographic estimates of sleep pressure/disruption. The aim of the present study was to assess the interactions between respiratory and spontaneous arousals in adults with suspected SDB, and to examine whether the SPS and the Epworth sleepiness scale (ESS) are correlated.
Retrospective chart review of 530 adult patients who underwent polysomnographic evaluation for suspected SDB in two medical centers was performed. Polysomnographic studies reports, patients' demographics and ESS scores were reviewed.
Spontaneous and respiratory arousal indices and the apnea-hypopnea index (AHI) displayed negative and positive correlations respectively (r=-0.25, r=0.97, P<0.0001) indicating reciprocal interactions between respiratory and spontaneous arousals during sleep. The AHI corresponding to the SPS at which the respiratory arousal/total arousal fraction exceeded the spontaneous arousal/total arousal fraction occurred at approximately 14/h of total sleep time (TST) (compared to 7/h TST in children) (P<0.001). No correlation was found between SPS values and ESS scores.
As in children, snoring adults exhibit reciprocal interactions between respiratory and spontaneous arousals that can also be expressed as a single quantitative measure, the SPS, which is highly dependent on the severity of SDB and could possibly serve as a more reliable index of sleep disruption, considering that the ESS is unrelated to either SPS or AHI.
Sleep Medicine 04/2006; 7(3):229-34. · 3.40 Impact Factor
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Sleep Medicine Reviews 01/2006; 9(6):415-8. · 6.93 Impact Factor
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ABSTRACT: Neuropeptide Y (NPY) and leptin are two peptides involved in the regulation of body weight, energy balance, and sympathetic tone. This study investigates the independent role of apneas and obesity on NPY and leptin plasma levels in patients with obstructive sleep apnea syndrome (OSAS). To this end we compared their values in 23 obese (body mass index > 30 kg/m2) and 24 nonobese (body mass index < 27 kg/m2) patients with OSAS, and in 19 obese and 18 nonobese control subjects without OSAS. Patients who used continuous positive airway pressure for more than 4 hours/night were reexamined 3 and 12 months later. We found that NPY levels were increased (p < 0.01) in patients with OSAS independently of obesity. Leptin levels were also increased in OSAS but this was mostly associated to obesity. Continuous positive airway pressure treatment reduced NPY levels in all patients and leptin levels only in nonobese patients (p < 0.01). We concluded that NPY and leptin plasma levels are increased in patients with OSAS. Yet, whereas the former appear independent of obesity, the latter are mostly associated with obesity.
American Journal of Respiratory and Critical Care Medicine 02/2005; 171(2):183-7. · 11.08 Impact Factor
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ABSTRACT: Orexin-A, also known as hypocretin, is a neuropeptide implicated in appetite and sleep regulation. Because the obstructive sleep apnea syndrome (OSAS) is characterized by obesity and excessive daytime sleepiness, we hypothesized that orexin-A levels may be abnormal in patients with OSAS. Further, since treatment with continuous positive airway pressure (CPAP) in patients with OSAS is very effective in normalizing daytime sleepiness, we also hypothesized that the chronic use of CPAP may influence plasma levels of orexin-A in these patients.
To evaluate plasma levels of orexin-A in patients with OSAS and the effect of CPAP treatment.
We compared the plasma levels of orexin-A in 13 healthy controls, 27 untreated patients with OSAS and 14 patients treated with CPAP during at least 1 year (4.5 +/- 0.5 h/night; mean +/- SEM). All patients had severe OSAS (apnea-hypopnea index, 57 +/- 4 h(-1)). Results: Orexin-A plasma levels were significantly lower in untreated (9.4 +/- 1.9 pg.ml(-1), p < 0.01) and treated patients with OSAS (4.2 +/- 1.5 pg.ml(-1), p < 0.001) than in healthy subjects (20.6 +/- 4.5 pg.ml(-1)). In untreated patients, orexin-A levels were not significantly related to daytime somnolence assessed by Epworth scale (r = -0.18, p = 0.37) or the body mass index (r = -0.13, p = 0.52).
Orexin-A plasma levels are abnormally low in patients with OSAS, independently of the level of somnolence and/or presence of obesity. These results suggest that these low orexin-A levels may be related to the pathogenesis of OSAS.
Respiration 71(6):575-9. · 2.26 Impact Factor
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ABSTRACT: Objective
The aim of this study was to compare the clinical, anthropometric, and polysomnographic characteristics of a broad group of patients with sleep apnea-hypopnea syndrome according to sex.Patients and methodsThe study, conducted in 6 Spanish university hospitals, included consecutive patients attended from 2003 through 2005 with an apnea-hypopnea index greater than 5. Groups were formed according to sex and then stratified into age subgroups of younger (≤ 45 years) and older patients (>45 years) for further comparison.ResultsThe study included 2464 men and 424 women. Women were older (mean [SD] age, 56 [12] years vs 51 [12] years), weighed more (body mass index, 31 [6] kg/m2 vs 30 [5] kg/m2), and had a larger hip circumference (119 [15] cm vs 111 [12] cm) and smaller neck circumference (38 [3] cm vs 42 [9] cm) than men (P<.001 in all cases). The degree of daytime sleepiness (Epworth scale) and the apnea-hypopnea index were similar in both groups, although women had a longer sleep latency (23[28] minutes vs 27 [32] minutes; P<.004) and a higher mean oxygen saturation (92% [4%] vs 91% [5%]) and minimum oxygen saturation (78% [11%] vs 75% [12%]; P<.0001) than men. On stratification by age, only weight differences between men and women were observed in the younger group whereas the older group also showed differences in oxygen saturation during sleep.Conclusions
Women with sleep apnea-hypopnea are more overweight than men and tend to seek medical attention at an older age. The clinical and polysomnographic variables were generally similar for men and women—the only differences were that sleep latency was longer and hypoxemia during sleep was more accentuated in women.ObjetivoComparar, en una cohorte amplia de pacientes con síndrome de apneas-hipopneas durante el sueño, las características clínicas, antropométricas y polisomnográficas en función del sexo.Pacientes y métodosEn el estudio, realizado en 6 hospitales universitarios españoles, se incluyó a pacientes consecutivos con un índice de apneas-hipopneas del sueño mayor de 5 h−1, que fueron evaluados entre 2003 y 2005. Se dividieron en función del sexo y, posteriormente, en función de la edad: pacientes jóvenes (≤ 45 años) y adultos (> 45 años).ResultadosSe ha estudiado a 2.464 varones y 424 mujeres. Las mujeres eran mayores (edad media ± desviación estándar: 56 ± 12 frente a 51 ± 12 años; p < 0,0001), pesaban más (índice de masa corporal: 31 ± 6 frente a 30 ± 5 kg/m2; p < 0,0001) y presentaban una mayor circunferencia de cadera (119 ± 15 frente a 111 ± 12 cm; p < 0,0001) y una menor circunferencia de cuello (38 ± 3 frente a 42 ± 9 cm; p < 0,0001) que los varones. El grado de somnolencia diurna (escala de Epworth) y el índice de apneas-hipopneas eran similares en ambos grupos, aunque el de mujeres presentaba una latencia de sueño más larga (23 ± 28 frente a 27 ± 32 min; p < 0,004) y una saturación de oxígeno media (un 92 ± 4 frente a un 91 ± 5%) y mínima menor (un 78 ± 11 frente a un 75 ± 12%; p < 0,0001) que los varones. Al diferenciar los grupos por edad, en el grupo de jóvenes sólo se mantenían las diferencias ponderales, mientras que entre los adultos reaparecían las diferencias en los valores de saturación nocturna.ConclusionesLas mujeres con síndrome de apneas-hipopneas durante el sueño son más obesas que los varones y consultan a una edad más avanzada. Desde el punto de vista clínico y polisomnográfico, no hay grandes diferencias en función del sexo. Únicamente la latencia de sueño es superior y la hipoxemia nocturna más acentuada.
Archivos de Bronconeumología ((English Edition)). 44(12):685-688.
