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Obstructive sleep apnea: an experience

Syed Suriya Arajmand Farooq, Nazia Mehfooz, Manzoor Ahmad Malik, Naveed Nazir, Khurshid Dar, Suhail Amin Patigaroo.

Abstract
Background: Obstructive sleep apnea (OSA) is a common disorder of repetitive pharyngeal collapse during sleep. It is more common among middle-aged adults. Obesity leads to and intensifies OSA. Epidemiologic studies have recorded relations of OSA with hypertension. The Berlin Questionnaire may find persons at high possibility for OSA and hence can evade costly polysomnography (PSG) studies, especially in resource-limited settings. This study is about our experience of Berlin Questionnaire and clinical characteristics of patients with OSA.

Objective: To reveal our experience of OSA in terms of (i) age/sex distribution; (ii) Berlin Questionnaire utility; (iii) clinical features; (iv) polysomnograhic findings; and (v) association with obesity and hypertension.

Materials and Methods: This prospective observational study was done in the Department of Chest Medicine and Department of ENT, Head and Neck Surgery of Government Medical College, Srinagar, Jammu and Kashmir. Outpatient department/inpatient department patients who showed positive scoring on Berlin Questionnaire were enrolled in the study. PSG was done in all of these patients. Clinical features, blood pressure, and body mass index (BMI) were noted in patients who showed positive PSG.

Result: This study included a total of 120 Berlin Questionnaire positive patients, of which 96 were positive on PSG. Positive predictability value of Berlin Questionnaire was 80% for both low- and high-risk cases. Majority of PSG positive cases were female subjects (68.75%) while males comprised 31.25% of PSG positive cases. Most common age group was 5165 years. Of PSG positive OSA patients, 41 (42.7%) showed mild disease, 30 (31.2%) moderate disease, and 25 (26%) severe disease. Most patients were grouped as per BMI into obese class II, and majorities were subjects with hypertension. In addition to snoring, other clinical features were dry mouth, excessive daytime sleepiness, and irritability.

Conclusion: Berlin Questionnaire is an important screening tool to detect suspected OSA patients. Although male subjects are more commonly seen to be affected in literature, we found female predominance. Most of these patients are middle-aged. Obesity is an important risk factor, and most of these patients show BMI > 30 kg/m2. Most of these patients present hypertension as a comorbidity.

Key words: OSA, polysomnography, Berlin Questionnaire, obesity, hypertension



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