Indian Journal of Sleep Medicine

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2019 | July-September | Volume 14 | Issue 3

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Original Article

Prabhu Subramani, Vishnumaya Ajikumar

Association between Quality of Sleep and Chronic Periodontitis: A Case-control Study

[Year:2019] [Month:July-September] [Volume:14] [Number:3] [Pages:3] [Pages No:43 - 45]

Keywords: Periodontitis, Quality of sleep, Sleep

   DOI: 10.5005/jp-journals-10069-0040  |  Open Access |  How to cite  | 


Background: Periodontitis is a ubiquitous chronic inflammatory disease affecting the supporting structures of the teeth, and if not promptly diagnosed and correctly managed can ultimately lead to tooth loss. Sleep is a complex and essentially biological process that is required on a daily basis for all humans regardless of age, sex, or ethnic origin. Since inflammation is characteristic of both chronic periodontitis and sleep deprivation, the present study was undertaken to study the relationship between quality of sleep and chronic periodontitis. Materials and methods: A case-control study was conducted among the outpatients reporting to Asan Memorial Dental College and Hospital. The sample size for the study was n = 198. The survey comprises of demographic data of study participants followed by an interviewer administered questionnaire to assess the quality of sleep using the Pittsburgh sleep assessment scale followed by clinical assessment to record periodontal health status using community periodontal index (CPI) by WHO. Results: Patients who were sleep deprived showed increased loss of attachment from 3 to 5 mm to more than 12 mm. Odds ratio showed that patients with periodontitis had 3.36 times the risk of sleep deprivation compared to patients without periodontitis. Conclusion: Lack of good quality of sleep will be a risk factor for periodontitis.


Original Article

Mansunderbir Singh

Comparison of Epworth Sleepiness Scale and STOP-BANG Questionnaire for Diagnosing Obstructive Sleep Apnea at a Tertiary Care Centre in North India: A Retrospective Study

[Year:2019] [Month:July-September] [Volume:14] [Number:3] [Pages:5] [Pages No:46 - 50]

Keywords: Epworth sleepiness scale, Obstructive sleep apnea, Polysomnography, Screening, STOP-BANG questionnaire

   DOI: 10.5005/jp-journals-10069-0042  |  Open Access |  How to cite  | 


Introduction: The diagnosis of obstructive sleep apnea (OSA) requires polysomnography (PSG). The screening of OSA utilizes questionnaires like the Epworth sleepiness scale (ESS) and the STOP-BANG questionnaire (SBQ) that have variable predictive value, as reported from the Western literature. Materials and methods: A retrospective cohort study was done in adult subjects (n = 80) presenting with symptoms of OSA. The demographic profile, ESS, and SBQ scores were evaluated. The level one recorded PSG was evaluated for apnea–hypopnea index (AHI) and positive airway pressure (PAP) therapy prescribed. Results: Of the 80 subjects, 75 were diagnosed as OSA on PSG. The mean age of the study group was 49 years, with 71% men and a mean BMI of 28.25 kg/m2. Epworth sleepiness scale ≥11 was in 62.66%, and SBQ ≥ 5 in 53% of the 75 subjects. Hence, both questionnaires failed to predict OSA in nearly half of the population. The mean AHI was 33.8/hour, and the mean continuous positive airway pressure (CPAP) was 10.05 cm H2O. The AHI had a significant correlation with BMI, ESS score, and CPAP. Epworth sleepiness scale had a 53% sensitivity and 60% specificity for diagnosing OSA using a cutoff of 11, whereas SBQ had a 68% sensitivity and 100% specificity using a cutoff of 5. Conclusion: The SBQ has a higher sensitivity and specificity to detect OSA than ESS as it envisages distinct clinical manifestations and risk factors of OSA. However, neither of the two can replace PSG.



AS Pon Thelac, Nileena N KakkattuMana

Medicolegal Aspects of Obstructive Sleep Apnea

[Year:2019] [Month:July-September] [Volume:14] [Number:3] [Pages:3] [Pages No:51 - 53]

Keywords: Disability, Health insurance, Legal implications, Liability, Litigations, Medicolegal, Obstructive sleep apnea

   DOI: 10.5005/jp-journals-10069-0039  |  Open Access |  How to cite  | 


The prevalence of obstructive sleep apnea (OSA) has been steadily increasing in recent decades. Correspondingly, the legal implications of this chronic disease are also being recognized and addressed. The insurance coverage for diagnosis and management of OSA and the medico-legal implications of undiagnosed OSA is clearly defined in some western countries. Health insurance coverage in India is predominantly for hospitalization and chronic disorders, such as OSA, are often not covered. In this review, we describe and compare the current status of medical and legal aspects in different countries, including issues related to health insurance, driving license, disability status, professional indemnity, and perioperative liabilities. We call to attention the need for more robust legislation in India relating to sleep disorders.



Sanchit Kumar

Routine Polysomnography before Bariatric Surgery: Is it Necessary or Optional?

[Year:2019] [Month:July-September] [Volume:14] [Number:3] [Pages:6] [Pages No:54 - 59]

Keywords: Bariatric surgery, Obstructive sleep apnea, Perioperative management

   DOI: 10.5005/jp-journals-10069-0041  |  Open Access |  How to cite  | 


Obstructive sleep apnea (OSA) is a condition characterized by episodes of apnea or hypopnea during sleep that result in excessive daytime sleepiness and a range of metabolic disturbances, which adversely affect cardiovascular, metabolic, and psychologic health. The common underlying mechanism for the same is periodic airway closure, which worsens with loss of pharyngeal muscle tone during sleep that results in significant obstruction and episodic apnea. Obesity is one comorbidity that commonly precipitates OSA and also worsens the long-term metabolic sequelae of OSA. With the ever increasing epidemic of obesity that is now starting to affect more developing countries such as India, more patients are undergoing bariatric surgery than before for a range of indications. This population provides a unique set of management issues that shall be the subject of this review.


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