The Availability in Spanish Public Hospitals of Resources for Diagnosing and Treating Sleep Apnea-Hypopnea Syndrome

• Published in: Archivos de bronconeumología (English ed.) 2004-06, Vol.40 (6), p.259-267
• Main Authors: Durán-Cantolla, J., Mar, J., de la Torre Muñecas, G., Rubio Aramendi, R., Guerra, L.
• Format: Article
• Language: English
• Subjects: Continuous positive airway pressure (CPAP); Conventional nocturnal polysomnography (PSG); Diagnosis; Diagnóstico; General population; Patients; Polisomnografía convencional nocturna; Presión positiva continua de la vía aérea (CPAP); Respiratory polygraphy (RP); Sleep apnea-hypopnea syndrome (SAHS); Síndrome de apneas-hipopneas durante el sueño (SAHS); Tratamiento; Treatment
• ISSN: 1579-2129; 1579-2129
• DOI: 10.1016/S1579-2129(06)70096-9

Sleep apnea-hypopnea syndrome is associated with an overall deterioration in the patient's health and affects between 1 and 2 million people in Spain. The objective of the present study was to evaluate the diagnostic and therapeutic resources available in Spain for dealing with this problem in terms of both infrastructure and human resources. We selected 461 general hospitals, 457 (99.1%) of which answered a questionnaire in the course of a telephone interview. At the time of response, 219 hospitals (47.5%) reported performing sleep studies. Conventional polysomnography was available in 53% of those hospitals, respiratory polygraphy was used in 42%, and oximetry in 5%. In 47% of the hospitals, continuous positive airway pressure was titrated empirically in most cases; the number of patients being treated with CPAP was 109 752, that is, 269 per 100 000 population in Spain. The level of resources available for diagnosing and treating sleep apnea-hypopnea syndrome, although improving, is clearly still inadequate. Currently, only 0.49 polysomnograph and 0.72 polygraph machines are available per 100 000 population, whereas 1 and 3 machines, respectively, are deemed necessary. Only 5% to 10% of the affected population has been diagnosed, and in 47% of the hospitals interviewed continuous positive airway pressure is not properly titrated. These results should be a clarion call to the health authorities to take the appropriate steps to address this health problem. El síndrome de apneas-hipopneas durante el sueño está asociado a un deterioro del estado de salud y constituye un problema sanitario que en España sufren entre 1 y 2 millones de personas. El objetivo del estudio fue evaluar cuáles son los medios diagnósticos y terapéuticos disponibles en España, tanto en infraestructu-ras como en recursos humanos, para abordar este problema. Se seleccionaron 461 hospitales generales y me-diante contacto telefónico se administró un cuestionario a 457 (99,1%). Realizan estudios de sueño 219 centros (47,5%). El 53% dispone de polisomnografía convencional, un 42% emplea la poligrafía respiratoria y un 5% la oximetría. Un 47% de los centros realiza titulaciones de presión positiva continua de la vía aérea de forma mayoritariamente empírica y existen en activo 109.752 aparatos, lo que representa 269 equipos por 100.000 habitantes. El nivel de recursos para el diagnóstico y el tratamiento del síndrome de apneas-hipopneas durante el sueño, a pesar de haber mejorado, es clarament