Apnea obstructiva del sueño en REM y su relevancia clínica

Obstructive sleep apnea in REM and its clinical relevance

Publicado 2024-11-18

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Apnea obstructiva del sueño en REM y su relevancia clínica.
rev. colomb. neumol. [Internet]. 2024 Nov. 18 [cited 2024 Dec. 21];. Disponible en: https://doi.org/10.30789/rcneumologia.v.n. 758
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https://doi.org/10.30789/rcneumologia.v.n..758
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Diego Fernando Severiche-Bueno
Fundación Neumológica Colombiana image/svg+xml
Roles:  
https://orcid.org/0000-0002-0976-3093
María Angelica Bazurto Zapata
Fundación Neumológica Colombiana image/svg+xml
Roles:  
https://orcid.org/0000-0001-9563-0539
Mostrar biografía de los autores

Diego Fernando Severiche-Bueno,

Médico especialista en neumología y medicina interna

María Angelica Bazurto Zapata,

Médica especialista en neumología y medicina interna. Experta en medicina del sueño, jefe del Centro de Medicina del Sueño de La Fundación Neumológica Colombiana. Presidente de la Asociación Colombiana De Medicina Del Sueño (ACMES) 2021-2023

Introducción. La apnea de sueño en REM es una entidad que se presenta en un subgrupo de pacientes con apnea obstructiva del sueño que ha generado interés en los últimos años.  Aunque es una condición  que se ha descrito desde hace varios años, sólo hasta ahora se han  comenzado a investigar sus diferencias con respecto a la apnea obstructiva de sueño de predomino en sueño NREM.  Es así como se ha buscado establecer la función del sueño REM y determinar las asociaciones que tiene con escenarios clínicos relevantes en la práctica diaria como la somnolencia diurna y la enfermedad cardiovascular. Este artículo, revisa la importancia del sueño REM y describe la evidencia disponible con respecto a la apnea de sueño en REM y su posible asociación con la somnolencia diurna, la hipertensión arterial sistémica y la enfermedad cardiovascular. 
Materiales y métodos. Se realizó una revisión narrativa de la literatura para explorar la información disponible sobre la AOS en REM. La búsqueda de estudios se extendió hasta mayo de 2023 y se llevó a cabo en las bases de datos Medline y Embase.
Resultados. La revisión destaca la importancia y fisiología del sueño REM, epidemiologia de la AOS en REM, apnea de sueño en REM y somnolencia diurna, apnea de sueño en REM e hipertensión arterial sistémica, apnea de sueño en REM y enfermedad cardiovascular y el impacto clínico de los pacientes con AOS leve, dado que generalmente no son considerados para tratamiento con CPAP. 
Conclusiones. En Colombia, no existen estudios que comparen la AOS en REM y NREM en términos de somnolencia diurna, hipertensión arterial, enfermedad isquémica del corazón o enfermedad cerebrovascular. Además, ninguno de los estudios previos se ha realizado en poblaciones a gran altitud. Esto presenta una oportunidad para avanzar en la investigación sobre esta condición y mejorar el manejo clínico de estos pacientes.

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