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ISSN 0188-9796 (Impreso)

2001, Número 2

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Rev Endocrinol Nutr 2001; 9 (2)


Apnea del sueño en el paciente obeso

Valencia-Flores M, Rebollar GV, Orea TA, Castaño-Meneses A, García-Ramos G, González-Barranco J

Idioma: Español
Referencias bibliográficas: 44
Paginas: 97-102
Archivo PDF: 158.02 Kb.


RESUMEN

El dormir puede representar en el paciente obeso, un período de estrés, el cual puede tener un impacto negativo sobre la vida diurna del paciente y en algunos casos, puede relacionarse con la muerte. Los trastornos del dormir más comunes en el obeso son las alteraciones en la respiración durante el sueño, las cuales pueden ser: Roncopatía, síndrome de apnea obstructiva de sueño (SAOS) e hipoventilación alveolar o una combinación de ellas. El 98% de los pacientes obesos mórbidos que acuden al Instituto Nacional de Ciencias Médicas y Nutrición “Dr. Salvador Zubirán” (INCMNSZ) presentan síndrome de apnea obstructiva de sueño y de ellos, el 60% presenta además hipoventilación alveolar. En la población de obesos, el indicador antropométrico que se asocia con la gravedad de la apnea, es la circunferencia del cuello. Los pacientes obesos con una circunferencia de cuello de 47 ó más centímetros, presentan índices de alteraciones en la respiración durante el sueño superiores o iguales a 65 eventos por hora de sueño, con saturaciones de oxígeno en sangre < 65%, y mayor frecuencia de arritmias cardíacas. La cronicidad de la apnea de sueño (10 ó mas años) acompañada de episodios repetidos de hipoxia e hipercapnia puede dar lugar a disminución en la respuesta ventilatoria ante la hipoxia y la hipercapnia diurna y esta alteración en los gases puede asociarse con hipertensión pulmonar. Los regímenes terapéuticos de mayor éxito son los que se dirigen a la reducción del peso corporal, eliminación de la apnea obstructiva de sueño y aumento del impulso ventilatorio.


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