There are two types of sleep scoring techniques for evaluation of obstructive sleep apnea (OSA) on polysomnography, they are manual and automated scoring. Manual scoring with expert technician is considered as a gold standard scoring technique. It evaluates total sleep time, stage of sleep, and apnoea or hypopnea index (AHI) better than automated scoring. However, this technique needs more manpower, money, and infrastructure. Automated scoring technique is simple, cost effective, and less time consuming. Both techniques can be performed with home sleep testing or in laboratory polysomnography. Though, automated scoring technique is less accurate in diagnosis of mild form of OSA, it is a viable option for moderate and severe OSA especially where the patient load is high and facilities are limited.
Mohammad Asim Siddiqui,
Subhash Kumar Wangnoo
Sleep of women differs in many respects from that of men. Women go through various phases in their life, each of these is associated with a unique hormonal milieu, which can affect the sleep significantly. Differences in the sleep of females and males have been documented across multiple studies. Various hormonal and physiological factors, as well as psychological and sociological factors, are thought to affect women's sleep.
Background/Objectives: The metabolic syndrome (MS) and obstructive sleep apnoea (OSA) are associated with an increased risk for cardiovascular disease. There are a number of studies investigating the relationship of OSA and MS, but the literature from India is scarce. This study aimed to investigate the relationship of OSA and MS in Indian subjects. The aim of this study is (1) the prevalence of MS in patients with OSA, (2) whether the presence of MS correlates with the severity of OSA, and (3) the association of OSA and the components of MS.
Methods: A cross-sectional, prospective study in which 110 adult patients undergoing overnight polysomnography was conductedand analysed for the presence of MS. OSA was defined as apnoea–hypopnoea index (AHI) =5 events/h. MS was diagnosed as per the definition by National Cholesterol Education Program, Adult Treatment Panel III criteria. Subjects were assessed for presence of OSA, MS, and correlation of severity of OSA with MS and association of each of the component of MS with OSA.
Results: Out of the 110 subjects, 81 were found to have OSA; the remaining 29 subjects were taken as controls. Out of 81 subjects with OSA, 61 (75.30%) had MS and 9 (31.03%) out of 29 controls had MS.
Interpretations/Conclusions: Subjects with OSA (1) had significantly higher prevalence of MS as compared to controls, (2) had higher systolic and diastolic blood pressures, (3) had hyperglycaemia, (4) had lower HDL cholesterol level, and (5) had differences in triglycerides and waist circumference that was not statistically significant.
Background: Obstructive sleep apnoea (OSA) is a common medical condition diagnosed by polysomnography (PSG). The long waiting timefor PSG prompted researchers to make various pre-test probability scores for triaging the need for PSG. While most scores were formulated and evaluated in preoperative cases, modified sleep apnoea clinical score (SACS), the adjusted neck circumference score (ANCS), was also assessed for pre-test probability testing in OSA. This study was undertaken to explore the role of ANCS in our clinical setting.
Methods: Retrospective analysis of 113 patients with an apnoea hypopnoea index (AHI) of more than 5/hour on PSG was performed. The age and sex distribution was studied. ANCS, SACS and ESS were reviewed and correlated with AHI.Descriptive and analytical statistical analysis was applied.
Results: Hundred and thirteen cases of OSA consisted of 82 men and 31 women were taken. Average AHI of the study group was found to be 34.6 (22.7) per hour. Twenty-six, 34, 53 patients had mild, moderate, severe OSA, respectively. The mean AHI in the mild, moderate, and severe OSA groups were 10.87, 21.19, and 54.21 per hour, respectively. Mean ANCS and SACS were found to be 47.8 (4.7) and 17.8 (12.9), respectively. ANCS of 43 or more could identify 89.3% of cases while SACS was positive (>8) in only 76%. ANCS severity did not correlate with the severity of OSA. Screening patients with ANCS and ESS (>10) could identify all cases of moderate to severe OSA.
Conclusion: It is proposedthat ANCS in adjunct with ESS has the potential to be a simple screening tool for OSA.