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Apneia obstrutiva do sono em adultos

  • Descripción general
  • Teoría
  • Diagnóstico
  • Manejo
  • Seguimiento
  • Recursos
Última revisión: 20 Aug 2025
Última actualización: 11 Dec 2024

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • obesidade
  • sexo masculino
  • anomalias maxilomandibulares
  • sonolência diurna excessiva
  • episódios de apneia
  • episódios de arquejo
  • sono não restaurador
  • insônia
  • macroglossia
  • ronco crônico
Todos los datos

Otros factores de diagnóstico

  • doença cardiovascular
  • ganho de peso
  • circunferência grande do pescoço
  • endocrinopatias
  • história de intubação difícil para anestesia geral; obstrução durante sedação
  • história familiar de AOS ou ronco
  • história de mucopolissacaridose
  • história de DRGE
  • história de síndrome de Down
  • história de extração dentária para liberar espaço
  • história de acidentes com veículo automotor
  • disfunção neurocognitiva
  • transtornos de humor
  • noctúria
  • disfunção erétil
  • cefaleias pela manhã
  • pirose/dispepsia
  • xerostomia
  • transpiração noturna
Todos los datos

Factores de riesgo

  • obesidade
  • sexo masculino
  • menopausadas (mulheres)
  • circunferência grande do pescoço
  • anomalias maxilomandibulares (por exemplo, estenose, retrognatia e palato arqueado alto)
  • aumento do volume dos tecidos moles (inclui amígdalas, adenoides e língua)
  • história familiar de AOS
  • ronco crônico
  • síndrome do ovário policístico (SOPC)
  • hipotireoidismo
  • Síndrome de Down
  • mucopolissacaridose
  • idade mais avançada
  • etnias negra, hispânica ou asiática
  • tabagismo
  • obstrução nasal
  • níveis dos hormônios sexuais
  • uso de bebidas alcoólicas
  • exposição ambiental à fumaça do tabaco
  • uso de opioides
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • polissonografia (PSG) presencial
  • PSG não laboratorial não supervisionada
  • testes de sono domésticos multicanais portáteis
  • endoscopia de fibra óptica sem sedação
Todos los datos

Pruebas emergentes

  • RNM dinâmica
  • endoscopia com sono induzido por medicamentos (ESIM)
  • aprendizado de máquinas

Algoritmo de tratamiento

Agudo

Índice de apneia-hipopneia (IAH) ou índice de eventos respiratórios (IER) ≥30 episódios/hora: nenhuma lesão anatômica distinta

IAH ou IER ≥5, mas <30 episódios/hora: nenhuma lesão anatômica distinta

índice de apneia-hipopneia (IAH) ou índice de eventos respiratórios ≥5 episódios/hora com lesões anatômicas distintas

En curso

AOS persistente pós-operatória

Colaboradores

Autores

Ofer Jacobowitz, MD, PhD, FAASM

Co-director of Sleep

ENT and Allergy Associates

Associate Professor

Department of Otolaryngology

Northwell/Zucker School of Medicine, Hofstra University

New York

NY

Disclosures

OJ is a scientific consultant for, and has received a consulting fee from Aerin Medical, LivaNova, Deerfield Catalyst, and Nyxoah. OJ has received research support from LivaNova for US Food and Drug Administration trial research. Aerin Medical has developed nasal valve treatment devices for nasal obstruction. Both LivaNova and Nyxoah have developed implantable neurostimulation systems for obstructive sleep apnoea. Zsquare has developed endoscopy systems. OJ is an author of a paper cited in this topic.

Peer reviewers

Carla Daltro, MD

Professor of Medicine

Bahiana School of Medicine and Public Health

Brazil

Disclosures

CD has been reimbursed by Sanofi-Aventis, Novartis, Merck Sharp Dohme, and Eli Lilly as an investigator of clinical trials.

Krishna M. Sundar, MD

Adjunct Assistant Professor

University of Utah

Director

Pulmonary & Critical Care Research

IHC Urban South Intermountain Utah Valley Pulmonary Clinic

Provo

UT

Disclosures

KMS declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American Academy of Sleep Medicine. The AASM International classification of sleep disorders – third edition, text revision (ICSD-3-TR). Jun 2023 [internet publication].Full text

Kapur VK, Auckley DH, Chowdhuri S, et al. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2017 Mar 15;13(3):479-504.Full text  Abstract

Patil SP, Ayappa IA, Caples SM, et al. Treatment of adult obstructive sleep apnea with positive airway pressure: an American Academy of Sleep Medicine clinical practice guideline. Sleep. 2019 Feb 15;15(2):335-43.Full text  Abstract

Yeghiazarians Y, Jneid H, Tietjens JR, et al. Obstructive sleep apnea and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2021 Jul 20;144(3):e56-67.Full text  Abstract

Ramar K, Dort LC, Katz SG, et al. Clinical practice guideline for the treatment of obstructive sleep apnea and snoring with oral appliance therapy: an update for 2015. J Clin Sleep Med. 2015 Jul 15;11(7):773-827.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

  • Differentials

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    • Sono insuficiente
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  • Guidelines

    • International classification of sleep disorders, 3rd edition, text revision (ICSD-3-TR)
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  • Patient information

    Apneia do sono em adultos (obstrutiva)

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  • Calculators

    Escala de Sonolência de Epworth (ESE)

    More Calculators
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