Nuevos aspectos patogénicos en el síndrome de apneas e hipopneas durante el sueño (SAHS)

Sleep apnea-hypopnea syndrome (SAHS) is defined as episodes of partial or complete cessation of airflow in the mouth and nose (obstructive sleep apnea) with secondary symptoms. To date, studies of SAHS have centered on diagnosis, treatment, and epidemiological features. However, new challenges such as study of the upper airway, where the obstruction occurs, and secondary effects, especially cardiovascular effects, must be met. Upper airway obstruction is produced at night and not during the day, suggesting the absence of mechanisms keeping the airway open at night. In part, SAHS must be considered a genetic disorder. A series of genes determine or favor the presence of several risk factors (obesity, ventilatory control, facial morphology, etc.) that may help to explain the finding that 15-20% of the population has an apnea-hypopnea index >10. There are also other genes giving rise to the phenotype, causing the obstructions to induce symptoms. The present review analyzes general considerations on inflammation and aspects of the upper airway, and lastly discusses associations with SAHS, especially with cardiovascular entities, and specifically free radical activity.