RESEARCH PAPER
Evaluation of usefulness of selected elements of medial examination in prognosticating the degree of severity of obstructive sleep apnea
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1
Klinika Chorób Wewnętrznych i Nadciśnienia Tętniczego z pododdziałem Chorób Zawodowych IMW w Lublinie
2
Zakład Badań Czynnościowych IMW w Lublinie.
3
Wyższa Szkoła Ekonomii i Innowacji w Lublinie
Corresponding author
Piotr Pardak
Klinika Chorób Wewnętrznych i Nadciśnienia
Tętniczego z pododdziałem Chorób Zawodowych IMW, ul Jaczewskiego 2,
20-090 Lublin
Med Og Nauk Zdr. 2014;20(3):282-286
KEYWORDS
ABSTRACT
The dissemination of knowledge concerning sleep-related breathing disorder (SRBD) resulted in an increase in diagnosing obstructive sleep dyspnea (OSD) in highly developed countries. The results of studies confirm the presence of a relationship between the degree of severity of OSD and the frequency of occurrence and course of such diseases as arterial hypertension, arrhythmia, coronary heart disease, and CNS diseases of vascular origin. Difficulties with the qualification of patients for diagnostics of OSD result in many unnecessary hospitalizations. The objective of the study was evaluation of the relationships between polygraphic indicators of the degree of severity of OSD and selected elements of medical examination, and the development of a model which would allow the prediction of the degree of severity of the disease based on these elements. Analysis covers data collected from 62 patients who were hospitalized or received ambulatory treatment at the Institute of Rural Health in Lublin. The mean value of the AHI index was 25.4, and saturation time below 90% (T90) 6.7 min. While seeking predictive characteristics of the degree of severity of OSD the following variables were analyzed: age, gender, body weight, height, neck circumference, scores according to the Epworth scale, nasal obstruction, tobacco smoking, and the occurrence of: the symptoms of snoring, interrupted breathing during sleep, and concentration disorders during the day. Statistical analyses were performed using Statistica 8.1 PL software. In order to assess the predictive value of individual variables in the preliminary study, and the construction of models of relationships, multifactor analysis of linear regression was applied. Analysis of the results obtained showed that the preliminary medical examination only to a limited extent allows assessment of the degree of severity of OSD. In prognosticating the degree of severity of OSD using the AHI gender, age and BMI were significant, and in prognosticating the degree of severity of OSD by means of the variable T90 – age and body weight.
REFERENCES (27)
1.
Hiestand D, Britz P, Goldman M, Phillips B. Prevalence of symptoms and risk of sleep apnea in the US population. CHEST 2006; 130: 780–786.
2.
Young T, Peppard P, Gottlieb D. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Resp Crit Care Med. 2002;165: 1217–1239.
3.
Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328: 1230–1235.
4.
Young T, Skatrud J, Peppard PE. Risk factors for obstructive sleep apnea in adults. JAMA 2004; 29(16): 2013–2016.
5.
Gottlieb DJ, Whitney CW, Bonekat WH, Iber C, James GD, Lebowitz M i wsp. Relation of sleepiness to respiratory disturbance index. The sleep heart health study. Am J Respir Crit Care Med. 1999; 159: 502–507.
6.
Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep- disordered breathing and hypertension. N Eng J Med. 2000; 342: 1378–1384.
7.
Mehra R, Benjamin EJ, Shahar E, Gottlieb DJ, Nawabit R, Kirchner HL, et al. Association of nocturnal arrhythmias with sleep-disordered breathing: The Sleep Heart Health Study. Am J Respir Crit Care Med. 2006; 173: 910–916.
8.
Peled N, Abinader EG, Pillar G, Sharif D, Lavie P. Nocturnal ischemic events in patients with obstructive sleep apnea syndrome and ischemic heart disease: effects of continuous positive air pressure treatment. J Am Coll Cardiol. 1999; 34: 1744–1749.
9.
Yaggi H, Concato J, Kernan W, Lichtman J, Brass L, Mohsenin V. Ob¬structive Sleep Apnea as a Risk Factor for Stroke and Death. N Eng J Med. 2005; 353: 2034–2041.
10.
Barnes M, McEvoy RD, Banks S, Tarquinio N, Murray CG, Vowles N, et al: Efficacy of positive airway pressure and oral appliance in mild to moderate obstructive sleep apnea. Am J Respir Crit Care Med. 2004; 170: 656–664.
11.
Pepperell JC, Ramdassingh-Dow S, Crosthwaite N, Mullins R, Jen¬kinson C, Stradling JR, et al. Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial. Lancet 2002; 359: 204–210.
12.
Simantirakis EN, Schiza SI, Marketou ME, Chrysostomakis SI, Chlouve¬rakis GI, Klapsinos NC, et al. Severe bradyarrhythmias in patients with sleep apnoea: the effect of continuous positive airway pressure treatment. A long-term evaluation using an insertable loop recorder. European Heart Journal 2004; 25: 1070–1076.
13.
Martinez-Garcia MA, Galiano-Blancart R, Roman-Sanchez P, et al. Continuous positive airway pressure treatment in sleep apnea prevents new vascular events after ischemic stroke. Chest 2005; 128: 2123–2129.
14.
Marin JM, Carrizo SJ, Vicente E, Agusti AG. 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: 1046–1053.
15.
Kushida CA, Littner MR, Morgenthaler T, Alessi CA, Bailey D, Coleman J Jr, et al. Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep. 2005; 28: 499–521.
16.
Madbouly EM, Nadeem R, Nida M, Molnar J, Aggarwal S, Loomba R. The role of severity of obstructive sleep apnea measured by Apnea-Hypopnea Index in predicting compliance with pressure therapy, a meta-analysis. American Journal of Therapeutics. (PAP)
http://www. journals.lww.com/americantherapeutics/pages/default.aspx (dostęp: 04.10.2012).
17.
Deegan PC, McNicholas WT. Predictive value of clinical features for the obstructive sleep apnoea syndrome. Eur Respir J. 1996; 9: 117–124.
18.
Resta O, Foschino-Barbaro MP, Legari G, et al. Sleep-related breathing disorders, loud snoring and excessive daytime sleepiness in obese sub-jects. Int J Obesity. 2001; 25: 669–675.
19.
Ohayon MM, Guilleminault C, Priest RG, Caulet M. Snoring and breathing pauses during sleep: telephone interview survey of a United Kingdom population sample. BMJ. 1997; 314: 860–863.
20.
Downey III R, Mosenifar Z, Gold PhM, Rowley JA, Wickramasinghe H, Sharma S i wsp. Obstructive Sleep Apnea.
http://www.medscape. com (dostęp: 06.01.2013).
21.
Rodsutti J, Hensley M, Thakkinstian A i wsp. A clinical decision rule to prioritize polysomnography in patients with suspected sleep apnea. SLEEP 2004; 27(4): 694–699.
22.
Pływaczewski R, Bieleń P, Bednarek M, Jonczak L, Górecka D, Śliwiń¬ski P. Wpływ obwodu szyi i wskaźnika masy ciała na zaawansowanie obturacyjnego bezdechu sennego u mężczyzn. Pneumonol Alergol Pol. 2008; 76: 313–320.
23.
Bielicki P, Byśkiniewicz K, Kumor M, Korczyński P, Chazan R. Obturacyjny bezdech podczas snu u osób młodych i w podeszłym wieku – różnice i podobieństwa. Pneumonol Alergol Pol. 2006; 74: 56–58.
24.
Bixler EO, Vgontzas AN, Lin HM, et al. Prevalence of sleep- disordered breathing in women: effects of gender. Am J Respir Crit Care Med. 2001; 163: 608–613.
25.
Peppard P.E, Young T, Palta M, et al. Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA 2000; 284: 3015–3021.
26.
Palla A, Digiorgio M, Carpenè N, Rossi G, D’Amico I, Santini F, et al. Sleep apnea in morbidly obese patients: prevalence and clinical predictivity. Respiration 2009;78:134–140.
27.
Bouloukaki I, Kapsimalis F, Mermigkis Ch, Kryger M, Tzanakis N, Panagou P, et al. Prediction of obstructive sleep apnea syndrome in a large Greek population. Sleep Breath 2011; 15(4):657–664.