TRATAMIENTO DE LA APNEA OBSTRUCTIVA DEL SUEÑO EN ADULTOS: UN ANÁLISIS INTEGRAL DE LAS TERAPIAS CONVENCIONALES Y LAS INNOVACIONES EMERGENTES

Abstract

Introduction: Obstructive sleep apnea (OSA) is a respiratory disorder characterized by recurrent upper airway obstruction during sleep, causing hypoxemia, excessive daytime sleepiness, and nocturnal awakenings. This health disorder significantly affects quality of life and can be caused by anatomical alterations, neuromuscular alterations, and factors related to a person's lifestyle. OSA is associated with cardiovascular, neurocognitive, and metabolic diseases, and also increases the risk of causing traffic and work accidents. Objective: To investigate the treatment strategies used for obstructive sleep apnea in adults, emphasizing conventional approaches and mentioning emerging surgical innovations. Materials and methods: A comprehensive literature review was conducted using electronic databases such as Scopus, PubMed, and Web of Science. The search terms included “obstructive sleep apnea,” “continuous positive airway pressure (CPAP) therapy,” “palatal and nasal surgeries,” and “mandibular advancement devices.” A total of 20 articles were analyzed, selected for their relevance and scientific rigor. Results: Obstructive sleep apnea is effectively treated by several approaches, depending on the individual characteristics of the patient and the severity of the disorder. The use of CPAP is the gold standard for the management of moderate to severe OSA, however, adherence to treatment remains a challenge. An option for patients with mild OSA who do not tolerate CPAP may be mandibular advancement devices. Lifestyle modifications, such as avoiding alcohol and sedatives, and weight loss, are essential for symptom reduction. Depending on the underlying cause of OSA, there are several surgical options that can be used to address it. Nasal surgeries, such as turbinate reduction and septoplasty, improve nasal ventilation. Palatal interventions, such as transpalatal advancement pharyngoplasty and uvulopalatopharyngoplasty (UPPP), widen the upper airway. Radiofrequency ablation of the base of the tongue or genioglossal advancement are hypopharyngeal procedures capable of reducing the collapse of posterior structures. In patients with severe OSA and craniofacial anomalies, maxillomandibular advancement becomes an integral surgical option. New technologies such as hypoglossal nerve stimulation have been shown to be positive in moderate to severe OSA, especially in patients who do not tolerate CPAP. Constant follow-up and telemedicine interventions provide better adherence to treatment and enable personalized monitoring. Conclusions: It is essential that the treatment of OSA be personalized, taking into account both anatomical factors, the severity of the disorder and also the user's preferences. Although positive pressure devices remain the mainstay of management, new surgical interventions and technological innovations promise exciting solutions for more complex cases. Early detection and treatment are essential to reduce complications and restore quality of life.