¿Qué es y cómo se hace una polisomnografía?

La polisomnografía es un estudio del sueño y sus diferentes fases que se realiza a una persona mientras esta duerme, con el fin de detectar posibles trastornos del sueño. Durante el descanso, se recogen de forma continua y simultánea datos de la actividad cerebral, de la respiración, del ritmo cardíaco, de la actividad muscular y de los niveles de oxígeno en la sangre al dormir.

Preparación y precauciones

Previo al comienzo de la prueba es necesaria la preparación del paciente. Para ello se aplican unos electrodos (sensores) en el cuero cabelludo y en otras partes de la cara y cuerpo, así como distintos sensores para valorar la función cardiorrespiratoria.

Para hacer la prueba es necesario:

  • No tomar estimulantes (té, café, colas, alcohol, etc.) ni dormir siesta el día de la prueba.
  • Haber cenado.
  • Tener el pelo limpio y sin lacas, lociones, cremas u otros productos similares.
  • Es recomendable no tener las uñas pintadas.
  • Tomar la medicación habitual (cuando sea el caso), con la excepción de fármacos que puedan afectar al sueño: en este caso es recomendable consultar previamente al personal sanitario.
  • Cargar pijama y útiles de aseo (cuando el examen sea en un sanatorio o clínica).

Características

Esta es una prueba indicada para el estudio de distintos trastornos del sueño y habitualmente se realiza durante la noche, en una habitación especial. Aunque en determinadas situaciones se puede realizar de manera ambulatoria, es decir en el domicilio particular del paciente con un equipo portátil, bajo la supervisión permanente de personal sanitario, para garantizar que se desarrolle correctamente.

La duración del estudio es de unas 8-9 horas, y todos los datos obtenidos son continuamente revisados por un especialista, que toma nota del tiempo que el paciente tarda en dormirse, la duración de las diferentes fases del sueño y el número de veces en que deja de respirar o su respiración es casi imperceptible (apnea del sueño). En algunos casos también se puede grabar al paciente en video.

Al día siguiente se retirarán todos los electrodos (algunos de ellos con un disolvente), para que el paciente pueda continuar con su actividad normal.

¿Cuándo se debe realizar?

El médico puede recomendar una polisomnografía nocturna si sospecha que su paciente padece alguna de las siguientes afecciones:

  • Apnea del sueño u otro trastorno respiratorio relacionado. En este trastorno, la respiración se detiene y se inicia repetidamente durante el sueño.
  • Síndrome de movimientos periódicos de las piernas. En este caso, las piernas se flexionan y extienden involuntariamente durante el sueño. En ocasiones, este trastorno está relacionado con el síndrome de piernas inquietas.
  • Narcolepsia. Con este trastorno, se experimenta una somnolencia abrumadora y ataques de sueño repentinos durante el día.
  • Trastorno de conducta durante el sueño MOR (Movimientos Oculares Rápidos).  Consiste en actuar físicamente los sueños mientras se duerme.
  • Comportamientos inusuales durante el sueño. El médico puede realizar este examen si el paciente realiza actividades inusuales durante el sueño, como caminar, moverse mucho o hacer movimientos rítmicos.
  • Insomnio crónico inexplicable. Si se registran problemas continuos para conciliar o para mantener el sueño, el médico también podría recomendar una polisomnografía nocturna.

Riesgos y resultados

Se trata de una prueba diagnóstica, no terapéutica, cuyos riesgos suelen ser mínimos. En personas con piel sensible, sobre todo en los niños, el raspado del cuero cabelludo o de la piel puede producir pequeñas irritaciones, que mejoran espontáneamente con el paso del tiempo.

La polisomnografía se realiza a sujetos de cualquier edad y en cualquier situación. La única excepción sería en personas con alergia conocida a algunos de los materiales utilizados para la prueba, aunque existe la posibilidad de sustituirlos por otros no alergénicos.

También es posible que en un primer momento el paciente experimente una sensación extraña al llevar conectados tantos instrumentos a su cuerpo, y especialmente a su cabeza, pero pasada esta primera sensación no tendrá mayor dificultad para quedarse dormido.

Una vez realizado el examen, la información recolectada es evaluada primero por un técnico en polisomnografía, que utiliza los datos para hacer un gráfico de las etapas y los ciclos del sueño. Luego, el médico del centro de sueño revisa esa información.

Pueden pasar hasta dos semanas antes de recibir los resultados del estudio. En una cita médica de seguimiento, el especialista repasa los resultados con el paciente. En función de los datos obtenidos, el médico analizará el posible tratamiento u otros exámenes que puedan resultar necesarios.

Fuentes: iis.es, mayoclinic.org, saludemia.com, resmed.com

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