Indian Journal of Sleep Medicine

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2019 | January-March | Volume 14 | Issue 1

ORIGINAL ARTICLE

Sameer Bansal

Clinical Profile of Obstructive Sleep Apnea Syndrome in a Tertiary Care Hospital in Western India

[Year:2019] [Month:January-March] [Volume:14] [Number:1] [Pages:6] [Pages No:1 - 6]

Keywords: Polysomnography, Sleep-related breathing disorders, Sleep scores,Apnoea–hypopnea index

PDF  |  DOI: 10.5005/jp-journals-10069-0031  |  Open Access |  How to cite  | 

Abstract

Background: Obstructive sleep apnea syndrome (OSAS) is an increasingly common, yet under-recognized and underreported sleep-related breathing disorder (SRBD) with momentous clinical, psychological, epidemiological, economic and healthcare implications. We conducted this study to decipher the clinical profile of patients with OSAS at the Pulmonary Medicine Department of a tertiary care center in Mumbai, India. Methodology: Patients presenting to our outpatient department with either symptoms of OSAS or who were referred with risk factors for OSAS were evaluated with polysomnography (PSG) after a comprehensive history, detailed clinical examination, calculation of various pre-test probability scores and relevant pre-requisite workup. Results: One hundred thirty patients were included, of these, 92 (71%) were male patients, while 38 were females (29%). Mean age of the study group was 49.5 years. Thirty-nine patients (30%) were overweight, while 35 (27%), 23 (17.7%) and 15 (11.5%) patients had mild, moderate and morbid obesity respectively. Average neck circumference in our group of patients was 40.1 (±4) cm. Average Epworth sleepiness score (ESS) for the group was 13.8 (±3.5). Average adjusted neck circumference score (ANCS) in our patients was 47.6 (±5.2). Average STOP-BANG score of our group was 5.3 (±1.4). The average APNEIC score was 4 (±1.2), and average Berlin score was 2.4 (±0.89). Of all the comorbidities present in these OSAS patients, hypertension was the commonest, present in 86 patients (66%), followed by GERD in 80 patients (61.5%), diabetes mellitus in 56 patients (43%), ischemic heart disease in 31 patients (24%), and hypothyroidism in 22 patients (17%). Mild pulmonary artery hypertension (PH) was present in 94 (72%), 20 patients had no PH (15.4%), while 11 patients (8.5%) had moderate PH. Seventy three patients (56%) had a normal spirometry, 36 patients (27.7%) had a restrictive, while 17 (13%) patients had an obstructive abnormality. Four patients had a spirometry suggestive of upper airway obstruction. PSG revealed 29 patients with mild OSAS (22%). 38 patients had moderate OSAS (29%), while 63 patients had severe OSAS (48.5%). Although there was a positive correlation seen between ANCS, STOP-BANG, APNEIC and ESS scores with the AHI, it was not a linear correlation. Conclusion: Obstructive sleep apnea syndrome (OSAS) in a tertiary center in India shows a predilection towards male sex, obesity, and a frequent association with cardiovascular comorbidities such as hypertension and IHD. Pretest probability scores help predict the likelihood of OSAS.

ORIGINAL ARTICLE

Anshuman Pattanaik, Arpita Priyadarshini, Sameer Vaidya, Nupur Pattanaik

Assessment of Sleep Quality Among Women of Childbearing Age by Pittsburgh Sleep Quality Index

[Year:2019] [Month:January-March] [Volume:14] [Number:1] [Pages:3] [Pages No:7 - 9]

Keywords: Pittsburgh sleep quality index, Pregnancy, Sleep quality, Women

PDF  |  DOI: 10.5005/jp-journals-10069-0032  |  Open Access |  How to cite  | 

Abstract

Background: Complaints of sleep disturbance are more prevalent among women. Women in childbearing age (15–49 years) are prone to sleep disturbances due to the menstrual cycle, pregnancy, and many other hormonal changes. So this study was designed with an objective to assess the sleep quality among women of childbearing age. Materials and methods: This cross-sectional study was conducted in sleep disorder clinic and laboratory of Srirama Chandra Bhanja Medical College, Cuttack, Odhisa, India between October 2014 and September 2015. Two hundred eleven women of childbearing age participated. Sleep was assessed by the Pittsburgh sleep quality index (PSQI) scale. Results: Among poor sleeper women 56.5% were from age 15 to 26 years which is higher from other age groups. About 61.9% of pregnant women were poor sleepers. About 83.3% of the second-trimester pregnant women were poor sleepers. Conclusion: Sleep abnormality in women of childbearing age starts from a very early age. Most pregnant women suffer from sleep abnormality mainly in the second trimester.

REVIEW ARTICLE

Harpreet Singh, Poonam Sharma, Pranav Kapoor, Raj K Maurya

Role of Malocclusion and Craniofacial Morphology in Obstructive Sleep Apnea

[Year:2019] [Month:January-March] [Volume:14] [Number:1] [Pages:8] [Pages No:10 - 17]

Keywords: Malocclusion, Orthodontics,Dentofacial deformities

PDF  |  DOI: 10.5005/jp-journals-10069-0033  |  Open Access |  How to cite  | 

Abstract

Being one of the most pervasive disorder with far-reaching adverse health implications, understanding the etiology of obstructive sleep apnea (OSA) in relation to craniofacial morphology and malocclusion is critical with regards to rational treatment planning, management, and long-term stability. The principal aim of this article is to present an invaluable insight into the role of malocclusion in the genesis of OSA by reviewing the orthodontic and sleep medicine literature pertaining to pediatric and adult OSA populations. The potential mechanisms underlying the association of malocclusion and OSA are also discussed.

CASE REPORT

Anshul Mittal, Vidushi Rathi

Therapeutic Cure of Obesity Hypoventilation Syndrome Resulting in Cure of Obstructive Sleep Apnea and Metabolic Syndrome

[Year:2019] [Month:January-March] [Volume:14] [Number:1] [Pages:4] [Pages No:18 - 21]

Keywords: Cure, Obesity hypoventilation syndrome, Obstructive sleep apnea

PDF  |  DOI: 10.5005/jp-journals-10069-0034  |  Open Access |  How to cite  | 

Abstract

Obesity hypoventilation syndrome (OHS) is a highly underdiagnosed and undertreated condition, especially in developing countries like India. We present a case of a young 26-year-old male with Metabolic syndrome along with severe OSA with OHS, who after weight reduction of 50 kgs over 2 years was practically cured of the same; with no requirement of PAP, insulin and oral medications in follow-up. This case highlights the importance of evaluating obstructive sleep apnea by a phenotypic approach so that appropriate treatment is given.

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