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Vol. 34. Issue 4.
Pages 177-183 (April 1998)
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Vol. 34. Issue 4.
Pages 177-183 (April 1998)
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Síndrome de la apnea obstructiva del sueño en la Comunidad Valenciana: situación actual, estudio de necesidades y perspectivas de futuro
Obstructive sleep apnea syndrome in the Community of Valencia: current situation, needs analysis and future outlook
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E. Chiner1, J.M. Arriero, J. Marco
Sección de Neumología. Hospital Universitari Sant Joan d’Alacant
J. Blanquer*
* Unidad de Cuidados Intensivos Respiratorios. Hospital Clínic Universitari de Valencia
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Con el fin de calcular las necesidades de infraestructura en el diagnóstico del síndrome de apnea de sueño (SAS) en la Comunidad Valenciana analizamos los recursos disponibles y el abordaje del SAS en Servicios de Neumología (SNM) y Neurofisiología (SNF) mediante un cuestionario administrado por teléfono en 23 de los 25 hospitales públicos. Sólo el 52% de los SNM y el 56% de los SNF efectuaban estudios de cualquier nivel, siendo de nivel I (polisomnogra-fía convencional) el 42% y el 100%, respectivamente, adscribiéndose a nivel IV (oximetría nocturna) el resto de SNM. Contaban con personal y local específico el 40% y sólo se realizaban estudios domiciliarios en el 17% de hospitales. Aunque el número de estudios anuales es de 2.000, sólo 1.100 son de nivel I, con grandes diferencias en el número por servicios, calculando en 16 meses la demora media. Sólo un hospital efectúa un abordaje multidisciplinario, siendo escasas las relaciones entre SNM y SNF. El número de polisomnógrafos de nivel I es 0,52/250.000 habitantes, y la prevalencia de tratamientos CPAP, de 36/100.000, inferior a otras comunidades. Se concluye que en la Comunidad Valenciana existe una infradotación de recursos técnicos y humanos, en algunos casos infrautilización de los mismos, escaso abordaje multidisciplinario por los diferentes especialistas implicados y largas demoras en el diagnóstico que condicionan la prescripción de tratamiento empírico. Atendiendo a los 100.000 pacientes con SAS calculados en la Comunidad Valenciana, sería necesario disponer de 14 polisomnógrafos frente a los 8 actuales, así como aumentar la dotación de personal para atender la demanda y reducir la demora.

Palabras clave:
Síndrome de la apnea de sueño
Polisomnografía
Recursos

To analyze the infrastructure needs for diagnosing sleep apnea syndrome (SAS) in the Community of Valencia, we studied available resources and the diagnostic approaches to SAS in departments of pneumology and neurophysiology in 23 of the 25 public hospitals by means of a telephone interview. Oniy 52% of pneumology departments and 56% of neurophysiology departments studied SAS at any level. Level I study (conventional polysomnography) was performed by 42% of the pneumology departments and 100% of the neurophysiology departments. The remaining pneumology units used nighttime oxymetry (a level IV technique). A special unit and trained personnel were available at 40% of hospitals. Home studies were performed by oniy 17%. Although 2,000 studies are performed annually, only 1,100 are level I and large interdepartmental differences were detected. The average waiting period was 16 months. Relations between pneumology and neurophysiology units were few and oniy one hospital took an interdisciplinary approach. The ratio of polysomnographs to inhabitants was 0.52/250,000 and the prevalence of nasal continous positive airway pressure treatment was 36/100,000, lower than in other communities. We conclude that Valencia is understaffed and under-equipped, and that in some cases resources are under-used. Interdisciplinary approaches are scarcely used by the various specialists involved and the waiting lists for diagnostic tests required for prescribing empirical treatment are long. To attend the approximately 100,000 SAS patients estimated to reside in Valencia, it woud be necessary to have 14 polysomnograph devices rather than the 8 available now, as well as to increase staff to meet demand and shorten waiting lists.

Key words:
Sleep apnea syndrome
Polisomnography
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