Revisión narrativa sobre la eficacia de los nuevos dispositivos comerciales para el cribado domiciliario de apnea obstructiva del sueño
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La apnea obstructiva del sueño (AOS) es la enfermedad respiratoria crónica con mayor prevalencia mundial. Según algunas series, afecta al 25% de la población mundial y su presentación varía en función del grupo etario, el sexo, el estado nutricional, la etnia, etc. A pesar de su frecuencia y del impacto implícito de esta enfermedad sobre la salud general, persiste ampliamente subdiagnosticada. Por consenso general, se acepta que la polisomnografía (PSG) es el patrón oro para el diagnóstico y estadificación de la AOS; sin embargo, este método es costoso, complejo y poco asequible.
En este contexto, surgen las nuevas tecnologías que integran sensores multimodales con aceptable capacidad para monitorización ambulatoria del ritmo circadiano, la actividad física y la estructura del sueño, entre otros parámetros. Su utilización es cada vez más extensa y prometen convertirse en herramientas innovadoras, capaces de optimizar el cribado a gran escala de AOS y de otros trastornos del sueño. Algunos dispositivos como los relojes, anillos y teléfonos inteligentes han sido ampliamente estudiados y se muestran útiles para el tamizaje, muchos de ellos con una sensibilidad (Se) del 90% y especificidad (Es) del 80%.
Pese al avance implícito en el desarrollo de las nuevas tecnologías en salud, hay que considerar que la capacidad de estos equipos varía según cada dispositivo y las poblaciones estudiadas. Mucha de esta tecnología emergente no cuenta con ningún tipo de validación externa o, en su defecto, requiere de mayores estudios; por lo tanto, es fundamental que su uso sea regulado.
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