Indian Journal of Sleep Medicine

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VOLUME 10 , ISSUE 3 ( July-September, 2015 ) > List of Articles

ORIGINAL ARTICLE

Clinical Prediction of OSA: A Retrospective Study

Niranjan Babu

Keywords : Obstructive sleep apnea (OSA), Polysomnography, Morbidity, Continuous positive airway pressure (CPAP)

Citation Information : Babu N. Clinical Prediction of OSA: A Retrospective Study. Indian Sleep Med 2015; 10 (3):101-104.

DOI: 10.5958/0974-0155.2015.00015.7

License: NA

Published Online: 01-06-2013

Copyright Statement:  NA


Abstract

Background: Obstructive sleep apnea (OSA) is a common yet unrecognized medical disorder with significant morbidity. Polysomnography (PSG) is considered as the gold standard to confirm the clinical diagnosis of OSA, to assess its severity, and to guide therapeutic choices. Continuous positive airway pressure(CPAP) constitutes the maintreatment option in most of the cases. Under-diagnosis of OSA and under-utilization of treatment options are the main challenges in developing countries and, therefore, identification using simple clinical predictors are important. Methods: A retrospective study was conducted from January 2012 to August 2015 in a Sleep Clinic based in Chennai. Patients with the symptoms of OSA, present during the study period, were included. Demographic, diagnostic, and comorbidity details of the patients were collected and analyzed with a specific focus on their symptoms as clinical predictors of OSA. Results and Conclusion: A total of 532 patients with the symptoms of OSA were included in the study (Males-81.8%/Females-18.2%; AverageAge-48.49;BMI-31.53; ESS score-10.37). Based on the prediction of clinical symptoms of OSA, these patients were recommended to PSG to confirm the diagnosis. 408 out of 532 patients (76.69%) underwent PSG or homebased portable study, of which, 97.3% (n=397)were positive for OSA based on the results of PSG. Snoring was the most common symptom followed by fatigue and excessive daytime sleepiness (EDS). Hypertension was the most common co-morbid illness associated with OSA. Profiling patients based on age, sex, symptoms, and comorbidities could increase our clinical index of suspicion of OSA.


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  1. Bixler EO, Vgontzas AN, Ten Have T, et al. Effects of age on the sleep apnea in men: I. Prevalence and severity. Am J Respir Crit Care Med1998; 157:144–48.
  2. Young T, Skatrud J. Peppard PE. Risk factors for obstructive sleep apnea in adults. JAMA 2004;291 :2013–6.
  3. Popovic RM, White DP. Influence of gender on the waking genioglossal electromyogram and the upper airway resistance. Am J Respir Crit Care Med 1995;152:725– 31.
  4. Popovic RM, White DP. Upper airway muscle activity in normal women: influence of the hormonal status. J Appl Physiol 1998;84:1055–62.
  5. Whittle AT, Marshall I, Mortimore IL, et al. Neck soft tissue and fat distribution: comparison in normal men and women by magnetic resonance imaging. Thorax1999;54:323–28.
  6. Peppard PE, Young T, Palta M, Dempsey J, Skatrud J. Longitudinal study of moderate weight change and sleepdisordered breathing. JAMA 2000;284:3015–21.
  7. Khoo SM, Tan WC, Ng TP, Ho CH. Risk factors associated with habitual snoring and sleep-disordered breathing in a multi-ethnic Asian population: a population-based study. Resp Med 2004;98: 557–66.
  8. Ekici M, Ekici A, Keles H, Akin A, Karlidag A, Tunckol M, et al. Risk factors and correlates of snoring and observed apnea. Sleep Med 2008;9:290–6.
  9. Mitler MM, Dawson A, Henriksen SJ, Sobers M, Bloom FE. Bedtime ethanol increases resistance of upper airways and produces sleep apneas in asymptomatic snorers. Alcohol Clin Exp Res 1998;12:801–5.
  10. Reddy EV, Kadhivaran T, Mishra HK, Sreenivas V, Handa KK, Sinha S, et al. Prevalence and risk factors of obstructive sleep apnoea among middle-aged urban Indians: a communitybased study. Sleep Med 2009;10:913–8.
  11. Jha A, Sharma SK, Tandon N, Lakshmy R, Kadhivaran T, Handa KK, et al. Thyroxine replacement therapy reverses sleep-disordered breathing in patients with primary hypothyroidism. Sleep Med 2006;7: 55–61.
  12. Effectiveness of Portable Monitoring Devices for Diagnosing Obstructive Sleep Apnea: Update of a Systematic Review [Internet].In:Lux L, Boehlecke B, Lohr KN, editors. Source Rockville (MD): Agency for Healthcare Research and Quality (US); pub 2004 Sep. AHRQ technology assessments. Last accessed June 2016.
  13. Ward KL, McArdle N, James A et al. A comprehensive evaluation of a two-channel portable monitor to “rule in” obstructive sleep apnea. J Clin Sleep Med. 2015;11(4):433– 44.
  14. Marin JM, Carrizo SJ, Vicente E, Aqusti AGN. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005;365:1046–53.
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