Manejo médico-dental de una paciente de la tercera edad con apnea obstructiva del sueño y roncopatía. Reporte de caso

[Medical-dental management of a third age patient with obstructive sleep apnea and snoring. Case report]

Fernando R Jaen1, Carmen Madrid2

1. Consultorios Royal Center, Panamá, Panamá.; 2. Servicio de Otorrinolaringología, CHDrAAM, CSS, Panamá, Panamá.

Publicado: 2022-08-30

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Resumen

Introducción: Los Desórdenes del Sueño (DDS) son condiciones médicas peligrosas y la Apnea Obstructiva del Sueño (AOS) y la Roncopatía están dentro de las categorías de las Respiratorias. Son aproximadamente 90 y están agrupadas en 6 tipos. Un tercio de la población puede sufrir alguno, pocos son diagnosticados o tratados y el promedio que dormimos es 6 horas de 8 requeridas. Su impacto en la salud y el bienestar general es considerable y conocido. Reporte de caso: Paciente femenina de 68 años que asiste para atención medica por ronquidos que perturbaban el sueño de sus familiares y mal sueño, con ronquidos estridentes al dormir que despertaba a sus familiares. Antecedentes médicos de importancia: hipertensión arterial (HTA) tratada desde hace 20 años. Se observó un riesgo cardiovascular moderado de 44%. Los diagnósticos de DDS del tipo Respiratorio fueron: 1. AOS, en grado leve. 2. Roncopatía. Conclusión: Los DDS son enfermedades peligrosas, incapacitantes y comunes y las respiratorias y las de movimiento, pueden y deben ser detectadas por los Médicos y los Odontólogos durante un examen de rutina.


Abstract

Sleep Disorders (SD) are dangerous medical conditions and Obstructive Sleep Apnea (OSA) and Snoring are amongst the Respiratory. There are approximately 90 different and are grouped in 6 types. One third of the population may be suffering of one, few are diagnosed or treated and the average time we sleep is 6 hours of 8 we need. Its impact on the general wellbeing and health is considerable and known. Temporomandibular Disorders (TMD) that according to the NIH, are dysfunctions of the temporomandibular joints and muscles and OSA are sisters. On October 23, 2017, the American Dental Association issued a mandate to its members that evaluation for OSA and similar disorders should be a part of the routine dental evaluation.  Regarding the relationship TMD and SD, we have more information: 1. In 2 (Respiratory and Movement) of the 6 groups of SD, there is a relationship with Dentistry.  2. Sleep depends on the health of the masticatory system (MS).  3. Some of the treatment modalities and manifestations are in the mouth. The intention of this case report is to present the standard of care and successful management of these DDS with the modality of Sleep Medicine and Dentistry.

Citas

[1] American Academy of Sleep Medicine. International Classification of Sleep Disorders: Diagnostic and Coding Manual. 3rd ed. Diagnostic and Coding Manual. 2014, p.53 y p.139. doi:10.1111/febs.12678 DOI: https://doi.org/10.1111/febs.12678

[2] The American Academy of Craniofacial Pain American Academy of Craniofacial Pain (AACP) Task Force on Mandibular Advancement Oral Appliance Therapy for Snoring and Obstructive Sleep Apnea. Special Consideration Regarding the Assessment and Management of Patients Being Treated with Mandibular Advancement Oral Appliance Therapy for Snoring and Obstructive Sleep Apnea. J Cranio. Volume 31, Issue 1. January 2013. DOI: https://doi.org/10.1179/crn.2013.002

[3] St-Onge M, Grander M, Bhatt D, et al. Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement from the American Heart Association. Circulation. November 1, 2016;134(18): e367-e386. DOI: https://doi.org/10.1161/CIR.0000000000000444

[4] Bansil P; Kuklina EV; Merritt RK; Yoon PW. Associations between sleep disorders, sleep duration, quality of sleep, and hypertension: results from the National Health and Nutrition Examination Survey, 2005 to 2008. J Clin Hypertens, 2011 Oct; Vol. 13 (10), pp. 739-43. DOI: https://doi.org/10.1111/j.1751-7176.2011.00500.x

[5] Rossi, C., Templier, L., Miguez, M., De La Cruz, J., Curto, A., Albaladejo, A., & Lagravère Vich, M. (2020, September 26). Comparison of screening methods for obstructive sleep apnea in the context of dental clinics: A systematic review. CRANIO®. DOI: https://doi.org/10.1080/08869634.2020.1823104

[6] John Viviano, Daniel Klauer, Steven Olmos & Joseph D. Viviano (2019) Retrospective comparison of the George Gauge™ registration and the sibilant phoneme registration for constructing OSA oral appliances, CRANIO®, DOI: https://doi.org/10.1080/08869634.2019.1694776

[7] Ayman Al-Dharrab (PhD) (2017) A randomized cross over study comparing the efficacy of two mandibular advancement appliances in the treatment of mild-moderate obstructive sleep apnea, CRANIO®, 35:6, 379-384, DOI: https://doi.org/10.1080/08869634.2016.1252563

[8] Aoben Chen, Maud S. Burger, Margriet A.W.J. Rietdijk-Smulders & Frank W.J.M. Smeenk (2020) Mandibular advancement device: Effectiveness and dental side effects. A real-life study, CRANIO®, DOI: https://doi.org/10.1080/08869634.2019.1708610

[9] G.J. Lavigne, A. Herrero Babiloni, G. Beetz, C. Dal Fabbro, K. Sutherland, N. Huynh, P.A. Critical Issues in Dental and Medical Management of Obstructive Sleep Apnea. Journal of Dental Research, November 2019. DOI: https://doi.org/10.1177/0022034519885644

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