Tratamiento del síndrome de apnea-hipopnea obstructiva del sueño (SAHOS) con presión positiva en la vía aérea (PAP)

In order to treat any disease, an adequate multidisciplinary management and involving the patient in the long term are necessary, since not treating patients implies an enormous burden for the health system and the society. Currently, different treatments for patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) can be found, being PAP (positive airway pressure) the most frequently chosen after ruling out anatomical abnormalities susceptible to surgery. Indications for PAP therapy include patients with apnea-hypopnea index (AHI) ≥15 events/hour or ≥5 and ≤14 events/hour and complaints of excessive daytime sleepiness, cognitive impairment and affective disorder or insomnia, documented arterial hypertension, coronary artery disease, or cerebrovascular event history. It is important to remember that AHI should be based on polysomnographic recording of sleep ≥2 hours. There are different modalities of treatment with PAP and intervention should be sought to improve adherence to the device, which is the main limiting factor for achieving efficacy in the treatment. The impact of OSAHS treatment has been investigated, but most of the reported studies are observational.