Él ronca, tú roncas, yo… NO

Vía - María Neupavert (flickr) — Vía – María Neupavert (flickr)

Como bien sabemos todos el ronquido es ese magnífico sonido que el que produce la mayoría de veces ni se entera de estar haciéndolo pero, que hace que el resto de seres vivos nos paremos a pensar en mil formas de despertarlo.

Bueno el post no va de “1000 maneras de despertar a un roncador”, sino de pistas para saber cuándo nos tenemos que preocupar si una persona ronca mucho.

Existe una enfermedad que se conoce como Síndrome de Apneas- Hipopneas del Sueño o SAHS, en medicina nos encantan las siglas, que se define como: “ un cuadro de somnolencia excesiva, trastornos cognitivo-conductuales, respiratorios, cardíacos, metabólicos o inflamatorios secundarios a episodios repetidos de obstrucción de la vía aérea superior durante el sueño”. Esta enfermedad se presenta con una tríada clínica:

- 1) Roncopatía crónica: es el síntoma con mayor sensibilidad, su ausencia hace poco probable el diagnóstico de SAHS. Sin embargo, la mayoría de roncadores (para la tranquilidad de todos) no tienen la enfermedad.

2) Apneas presenciadas: es el síntoma con mayor especificidad, la cual aumenta si son observadas de forma repetida durante la misma noche y sin son prolongadas.

*Apnea: es una parada respiratoria >10 segundos, puede ser obstructiva si presenta una presencia de esfuerzo respiratorio o central si hay ausencia de dicho esfuerzo.

3) Hipersomnia diurna o tendencia a dormirse involuntariamente ante situaciones inapropiadas: es el síntoma más importante, porque marca la intensidad clínica del SAHS. Hay que tener en cuenta que existen otras causas de hipersomnia y antes de clasificar a alguien como SAHS hay que descartar otros motivos.
Para medir la hipersomnia existen métodos objetivos (diferentes test) y subjetivos, entre estos últimos el test de Epworth, muy usado en clínica para el seguimiento.

Cuando alguno de esos síntomas comentados aparecen el siguiente paso, suele ser, una PSG (polisomnografía, exisitiendo de diferentes tipos. Habiéndolas desde muy sencillas hasta las que analizan el electroencefalograma, eligiendo una u otra según el origen que se sospeche. Con esta prueba se analiza el índice de apneas-hipopneas (IAH) cuya escala se valora del siguiente modo:

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IAH leve 5-14’9
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El tratamiento de esta patología se basa en medidas higiénicas del sueño, como pueden ser:

Dormir de costado, y con un horario lo más parecido posible todas las noches.
Evitar bebidas estimulantes a partir de la hora de la comida.
Evitar uso de fármacos sedantes.
Cenar ligero, acostarse con la digestión hecha, y evitar picar entre horas.
Evitar fumar
Evitar bebidas alcholicas
PERDER PESO, siendo esta la medida más importante.

Y el tratamiento definitivo es la CPAP, que es una máquina que crea un flujo de aire de presión positivo que mantiene abierta la vía aérea, evitando el colapso de ésta y por tanto evitando las apneas.