Keywords
Apnea obstructiva del sueño
Obstrucción nasal
Polisomnografía
Categories
How to Cite
Abstract
Resumen
La apnea obstructiva del sueño (AOS) es un trastorno respiratorio frecuente caracterizado por episodios repetidos de colapso de la vía aérea superior durante el sueño. A la par de la pandemia metabólica y la obesidad, la prevalencia de AOS ha aumentado gradualmente en las últimas décadas. La AOS es compleja y en ella interactúan factores anatómicos y funcionales que condicionan la estabilidad de la vía aérea. Entre ellos, la obesidad incrementa la colapsabilidad faríngea mediante el depósito de tejido adiposo perifaríngeo, la reducción del volumen pulmonar y las alteraciones del control ventilatorio. Por otro lado, la obstrucción nasal modifica la dinámica del flujo aéreo, aumenta la resistencia inspiratoria y favorece la respiración oral, lo que contribuye a la inestabilidad de los segmentos más distales de la vía aérea. Aunque el índice de apnea-hipopnea continúa siendo el principal parámetro diagnóstico de la AOS, otros parámetros, como la carga hipóxica y la duración de los eventos, han mostrado una mejor correlación con desenlaces clínicos. La evaluación de la obstrucción nasal requiere un enfoque integral que combine hallazgos anatómicos, métodos objetivos y escalas subjetivas, como la NOSE, que permite cuantificar la severidad de los síntomas y la respuesta al tratamiento. La interacción entre la obesidad y la obstrucción nasal modula la magnitud de la AOS. Su abordaje clínico debe considerar ambos componentes para una mejor caracterización de la enfermedad y el desarrollo de estrategias terapéuticas más integrales.
Palabras clave: Apnea obstructiva del sueño; obesidad; obstrucción nasal; polisomnografía
Abstract
Obstructive sleep apnea (OSA) is a common respiratory disorder characterized by recurrent episodes of upper airway collapse during sleep. Alongside the growing obesity epidemic and the increasing prevalence of metabolic disorders, the prevalence of OSA has risen steadily over recent decades. OSA is a complex condition involving the interaction of anatomical and functional factors that determine upper airway stability. Among these, obesity increases pharyngeal collapsibility through peripharyngeal fat deposition, reduced lung volumes, and alterations in ventilatory control. In addition, nasal obstruction modifies airflow dynamics, increases inspiratory resistance, and promotes oral breathing, thereby contributing to instability of the more distal segments of the upper airway. Although the apnea-hypopnea index remains the primary diagnostic parameter for OSA, other metrics, such as hypoxic burden and event duration, have shown stronger correlations with clinically relevant outcomes. Assessment of nasal obstruction requires a comprehensive approach that integrates anatomical findings, objective measurements, and subjective instruments, such as the Nasal Obstruction Symptom Evaluation (NOSE) scale, which allows quantification of symptom severity and treatment response. The interaction between obesity and nasal obstruction modulates the severity of OSA. Clinical management should therefore consider both components to achieve a more comprehensive characterization of the disease and to support the development of more integrated therapeutic strategies.
Keywords: Obstructive Sleep Apnea; Obesity; Nasal Obstruction; Polysomnography.
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