Poligrafia noturna como ferramenta para diagnóstico da apneia obstrutiva do sono e indicação de ventilação não invasiva em pacientes com doenças neuromusculares atendidos em um ambulatório especialzado do SUS

Abstract

Introduction: Sleep plays a fundamental role in physical and mental health throughout all stages of life. Sleep-related breathing disorders compromise its quality, especially obstructive sleep apnea (OSA). Patients with neuromuscular diseases (NMDs) are among the groups at highest risk for developing OSA, due to progressive weakness of the respiratory muscles, bulbar dysfunctions, and changes in ventilatory control. Early identification of these disorders is essential to optimize the clinical management and quality of life of these patients. Objectives: This study aimed to evaluate the prevalence of OSA through home polygraphy in a public university hospital during respiratory assessments of patients with NMDs and its contribution to the indication of noninvasive ventilation. Materials and Methods: Data collection was carried out in an outpatient clinic specialized in NMD at a Public University Hospital, between May 2021 and June 2024, using medical records and exams such as spirometry to assess pulmonary respiratory function, home polygraphy and sleep assessments using the Epworth Sleepiness Scale and a symptom questionnaire. Data were analyzed using SPSS and JAMOVI, using statistical tests according to the distribution of variables and type of data. Normality tests, comparison of means and association between variables were applied, with significance level set at p ≤ 0.05. Results: A total of 74 patients were included. The most prevalent NMDs were muscular dystrophy (29.7%), myasthenia gravis (n = 13; 17.6%) and amyotrophic lateral sclerosis (n = 11; 14.9%). Apnea-hypopnea index values were higher in the supine position. ESS revealed that 40.5% of patients had scores indicative of excessive daytime sleepiness. Conclusion: The findings reinforce the importance of early diagnosis of OSA in patients with NMDs.