Distúrbios Respiratórios do Sono: evolução natural e fatores associados observados em um estudo longitudinal prospectivo de base populacional

• Autor(a) principal: Tufik, Sergio Brasil [UNIFESP]
• Data de Publicação: 2020
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/001300000tv9x
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.xhtml?popup=true&id_trabalho=9156566; https://repositorio.unifesp.br/handle/11600/58775
• topic: Sleep; Upper Airway Resistance Syndrome; Obstructive Sleep Apnea Syndrome; Sleep disordered breathing; Inspiratory flow limitation; Sono; Síndrome da Resistência das Vias Aéreas Superiores; Apneia Obstrutiva do Sono; Distúrbios respiratórios do sono; Limitação do fluxo aéreo

Introduction: Sleep-disordered breathing is extremely prevalent in contemporary society and is mainly represented by obstructive sleep apnea (OSA), which is widely studied and with significant outcomes confirmed by previous studies. The upper airway resistance syndrome (UARS) is much less understood and studied. In addition, few longitudinal population-based studies are available to evaluate the progression of these disorders. Objective: To evaluate the progression of sleep-disordered breathing and its epidemiological characteristics in a longitudinal study of a representative sample of a large urban center, with an emphasis on the analysis of UARS. Methods: Research involving volunteers from EPISONO, an epidemiological study focused on sleep disorders and related factors in adults of Sao Paulo, Brasil, in 2007 and follow-up in 2015. Of the 1042 volunteers originally included in EPISONO, 876 were included in cross-sectional analyzes with data from 2007 and 571 of these were evaluated across time. Results: UARS and the control group differ significantly in terms of excessive daytime sleepiness, fatigue, depression and anxiety. In addition, UARS has been shown to be a risk factor for the development of OSA (OR=11.75; 95%CI=2.01–68.544; p = 0.006). Additionally, the prevalence of UARS was estimated at 3.1% (95%CI=1.9–4.2) for a representative sample of the city of São Paulo in 2007. Conclusions: In general, sleep-disordered breathing appears to be aggravated over time. UARS is characterized as a non-hypoxic sleep-disordered breathing, appearing to be part of the same continuous spectrum of OSA, evolving to this condition in the long term. The typical phenotype of the individual with UARS was mainly a non-obese female, presenting a decrease in prevalence with increasing age. On the other hand, OSA was characterized mainly in obese males, showing an increase in prevalence with increasing age.