Argentine consensus on sleep-related breathing disorders

Due to the increased interest of the medical community in sleep disorders a n experts meeting was called to establish common criteria for diagnosis, tr eatment and management of these disorders. Adult prevalence of sleep apnea/ hipopnea syndrome (SA/ HS) is about 2-4% and increases in the elderly. Snor ing and excessive daytime somnolence (EDS) are habitual symptoms. Increased risk to cardiovascular disorders and traffic accidents are the major compl ications. Increased upper airways resistance syndrome is a recently describ ed syndrome which also involves EDS. A standardized questionnaire was devel oped and its use was recommended in order to evaluate patients with respira tory sleep disorders (RSD). Polysomnography was established as gold standar d in the diagnosis of RSD. Minimal requirement of split night studies and s creening studies was also standardized and specific indications were summar ized. Medical treatment of obesity in relationship to RSD was analyzed. Nas al continuous positive airways pressure (CPAP) was established as the first choice treatment of SA/HS. Titration of CPAP was standardized. Oral applia nces with mandibular advancement could be considered in the treatment of sn oring patients without SA/HS and in patients with increased upper airways r esistance syndrome. Uvulopalatopharingoplasty can only be performed in snor ing patients in whom the presence of SA/HS has been dismissed by polysomnog raphy. Management of patients must include periodic clinical control. EDS m ust be determined by Epworth test. In order to evaluate CPAP compliance the use of time-controlled devices is highly recommended.