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Acta Otorrinolaringológica Española Where are we heading with sleep medicine? A study of multidisciplinary units in ...
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Vol. 76. Issue 4.
(July - August 2025)
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Vol. 76. Issue 4.
(July - August 2025)
Letter to the Editor
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Where are we heading with sleep medicine? A study of multidisciplinary units in Spain

¿Dónde se dirige la medicina del sueño? Un análisis de las unidades mulitidisciplinares en España
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Laura Rodriguez Alcalaa, Carlos O’Connor-Reinaa,b,
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carlos.oconnor@quironsalud.es

Corresponding author.
, Carlos Egeac, F. Javier Puertasd, Milagros Merinoe, Marina Carrascof, Jose Maria Ignaciog, Peter Baptistah, Guillermo Plazai
a Otolaryngology Department, Hospital Quironsalud Marbella, 29670 Marbella, Spain
b President SDB Comission SEORL Otolaryngology Department, Hospital Quironsalud Marbella, 29670 Marbella, Spain
c Organización Sanitaria Araba, Instituto Bioaraba, 01009 Araba, Spain
d Neurophysiology and Sleep Unit, La Ribera, University Hospital-FISABIO, Catholic University of Valencia “San Vicente Martir”, Valencia, Spain
e Sleep Unit, Hospital Universitario La Paz, 28046 Madrid, Spain
f Otorhinolaryngology Department, Hospital Doctor Peset, CP 46017 Valencia, Spain
g Neumology Department, Hospital Quironsalud Marbella, 29670 Marbella, Spain
h Otorhinolaryngology Department, Otorhinolaryngology Dep., Al Zahra Hospital, Dubai 124412, United Arab Emirates
i Otorhinolaryngology Department, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, CP 28042 Madrid, Spain
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Dear Editor,

Spain currently has 24 multidisciplinary units for the treatment of OSA.1 However, the delay in diagnosis remains comparable to that of 15 years ago. In 2024, an observational study in a tertiary hospital showed that the mean waiting time for a respiratory polygraphy was approximately 225 days, reflecting the insufficient responsiveness of the health care system to this problem.2

Accreditation of sleep units in Spain has evolved thanks to initiatives by the Spanish Society of Pneumology and Thoracic Surgery (SEPAR) and the Spanish Federation of Sleep Medicine Societies (FESMES). Since 2022, 79 units have been accredited at different levels of complexity. However, heterogeneity in the training of professionals remains a major limitation. An analysis of training programmes published in the Spanish Official State Gazette reveals that key specialties, such as otorhinolaryngology and pneumology, hardly devote any significant attention to OSA in their training curricula.3

In addition to training, research into new diagnostic and treatment technologies has gained prominence in recent years. Wearable devices and apps for OSA monitoring have been developed, although their clinical validation is still in progress. In terms of treatment, the introduction of hypoglossal nerve stimulation implants in public hospitals and myofunctional therapy have shown promising results as alternatives or adjuncts to continuous positive airway pressure (CPAP).4 However, improving adherence remains crucial, as many patients do not reach the recommended duration of use to obtain significant cardiovascular benefits.

In conclusion, OSA represents a growing challenge in Spain. Although advances have been made in technology and accreditation of sleep units, under-diagnosis and lack of prevention strategies remain outstanding problems. Greater integration of primary care, improved training of professionals and reinforcement of government initiatives to reduce the impact of this pathology on the population are essential.

CRediT authorship contribution statement

L.R.A. data analysis, manuscript review; C.O.-R. study design, data collection, manuscript review; C.E. manuscript review; F.J.P. manuscript review; M.M manuscript review; M.C. manuscript review; P.B. data analysis, manuscript review; J.M.I. manuscript review; G.P., data collection, manuscript review. All authors have read and agreed to the published version of the manuscript.

Consent informed patients

Due the characteristics of this study (narrative review) these declarations are not necessary.

Institutional review board statement

Not applicable.

Funding

This research received no external funding.

Data availability

The data presented in this study are available on request from the corresponding author.

Declaration of competing interest

The authors declare no conflicts of interest.

Acknowledgments

None.

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