Análisis de los métodos más eficaces para el cribado del síndrome de apnea obstructiva del sueño en la clínica dental

Abstract

Introduction: Obstructive sleep apnea (OSA) is a sleep-related breathing disorder, that determines severe sequelae on affected people's health. The gold standard to diagnose OSA is the polysomnography, which however is expensive, time-consuming, laborintensive and not always available. Therefore, OSA is underdiagnosed, and thus, given the severity of its consequences, it represents a significant burden for the health system.To solve this problem easy-to-perform screening methods are needed to identify subjects at high risk of OSA. Dentists are particularly well placed to carry out this initial tests.Objective: To review the available bibliographic data to identify the best screening methods to detect potential OSA patients during dental clinical practice, both for adults and children. Methods:Relevant studies published up to April 2021 were sourced from PubMed, Embase, MEDLINE, Cochrane, and LILACS databases.Results: 93 studies were selected, 52 for adults and 41 for children. The screening methods available to the dentist included questionnaires, pulse oximetry, analyses of the upper airways and anatomical factors. Some of these were found to be adequate tools for certain specific purposes, but none of them presented all the characteristics required to be considered a good screening method for OSA on a standalone basis. It is thus necessary to combine multiple of them to achieve a sufficient precision in OSA detection. This is supported by some of the reviewed studies, but it should be further researched.Dentists have a fundamental role in early detection of potential OSA cases since they can use the methods described in this review to perform an initial screening of the population and address the identified subjects to sleep physicians. Sleep Apnea Clinical Score Flemons WW y cols. (62) 1994 4 + tabla de putuación Cuestionario es el de Berlín (CB) Conferencia sobre el sueño en atención primaria celebrada en Berlín. (63) 1996 11 Escala NOSE Stewart MG y cols. (66) 2004 ASA checklist Grupo de trabajo de la Sociedad Americana de Anestesiólogos. (68) 2006 12 Apnea Risk Evaluation System (ARES) Levendowski DJ y cols. (69) 2007 5 + EES STOP Chung F y cols. (70) 2008 STOP-Bang Chung F y cols. (70) 2008 Four-Variable Screening Tool (4-VST) Takegami M y cols. (71) 2009 Ecuación de 4 variables.