Aplicação do modelo morfométrico de Kushida em pacientes com distúrbios respiratórios do sono

Abstract

1 Otorhinolaryngologist and sleep medicine specialist, Master's degree graduate student at UNIFESP, collaborating physician of the otorhinolaryngology unit at FMABC.2 Doctor in Medicine, Pneumologist and sleep medicine specialist. The morphometric model is a useful screening test to investigate the possibility of OSAS in patients during initial office visits. Aim: To evaluate the clinical applicability of the Kushida morphometric model in a sample of patients with sleep-disordered breathing, and to define a cutoff value to differentiate patients with mild, moderate and severe apnea. Method: A sample of 80 patients with sleep respisratory disorder was studied. Patients were aged between 18 and 75 years, of both genders and had been submitted previously to polysomnography. The model cutoff value to distinguish between patients with or without apnea is 70. Results: In this sample, the model cutoff value in all four groups was less than 70. It was impossible to establish a cutoff value according to the gravity of the condition, due to the proximity and the nonlinear increase in the values presented by the nonapneic group and those with mild and moderate apnea. Conclusion: The Kushida morphometric model can be applied in clinical practice to a selected sample and it was impossible to establish a cutoff value to separate patients with obstructive sleep apnea-hypopnea syndrome according to severity.

Alterações Otorrinolaringológicas na Síndrome da Apneia Obstrutiva do Sono

“…A diferença de pressão intra e extraluminal, tônus vasomotor da musculatura faríngea e forças adesivas agindo sobre a mucosa podem colaborar com o estreitamento ou um colapso da VAS. 4,5 Não só fatores anatômicos atuam nesta complexa relação mecânica, como se pode observar em doenças endócrinas (hipotireoidismo) e metabólicas (obesidade) influencim a propensão a um evento obstrutivo na SAOS. A redução do fluxo aéreo promove, através de estímulos a receptores na mucosa faríngea, breves despertares durante o sono, levando a uma fragmentação na sua continuidade que causa sonolência excessiva diurna e diversos outros sintomas clínicos e neurocognitivos associados a SAOS.…”