Nova Abordagem da Apnéia Obstrutiva do Sono na Atenção Primária à Saúde

Abstract

Objective: To analyze the results of the application of a new modality of Type 4 Polysomnography, with the issuance of a remote report via Telemedicine in the diagnosis of obstructive sleep apnea in the primary health care of the Unified Health System. Methods: This is a descriptive and cross-sectional study, with patients over 18 years of age referred to a medical appointment for presenting a diagnostic hypothesis of obstructive sleep apnea. The included patients who agreed to participate in the research were selected by primary care professionals and answered three questionnaires for the diagnosis of obstructive sleep apnea. Next, these patients underwent type 4 polysomnography (Biologix®). The results of the questionnaires were compared with the results of polysomnography. Results: Of the 186 selected patients, 146 met the inclusion criteria. The patients had a mean age of 58 ± 14 years and 61.6% were women; mean BMI was 32 ± 7.1 kg/m²; 86.4% had comorbidities. Confirmation of obstructive sleep apnea occurred in 84.5% of cases. The concordance index of the questionnaires with the polysomnography results was higher in the forms previously identified as moderate to severe. Conclusions: The approach to obstructive sleep apnea in Primary Health Care using Type 4 Polysomnography, with remote diagnosis via Telemedicine, proved to be practical and feasible, easy and quick to perform, with excellent agreement with the assessments obtained in diagnostic questionnaires. This fact demonstrates that the new low-cost polysomnography method for diagnosing obstructive sleep apnea can be used in primary health care, allowing greater access to SUS users.