Clinical Prediction of OSA: A Retrospective Study

Obstructive sleep apnea (OSA) is a common yet unrecognized medical disorder with significant morbidity. Polysomnography (PSG) is considered as the gold standard to confirm the clinical diagnosis of OSA, to assess its severity, and to guide therapeutic choices. Continuous positive airway pressure(CPAP) constitutes the maintreatment option in most of the cases.Under-diagnosis of OSA and under-utilization of treatment options are the main challenges in developing countries and, therefore, identification using simple clinical predictors are important.

A retrospective study was conducted from January 2012 to August 2015 in a Sleep Clinic based in Chennai. Patients with the symptoms of OSA, present during the study period, were included. Demographic, diagnostic, and comorbidity details of the patients were collected and analyzed with a specific focus on their symptoms as clinical predictors of OSA.

A total of 532 patients with the symptoms of OSA were included in the study (Males-81.8%/Females-18.2%; Average Age-48.49; BMI-31.53; ESS score-10.37). Based on the prediction of clinical symptoms of OSA, these patients were recommended to PSG to confirm the diagnosis. 408 out of 532 patients (76.69%) underwent PSG or homebased portable study, of which, 97.3% (n=397)were positive for OSA based on the results of PSG. Snoring was the most common symptom followed by fatigue and excessive daytime sleepiness (EDS). Hypertension was the most common co-morbid illness associated with OSA. Profiling patients based on age, sex, symptoms, and comorbidities could increase our clinical index of suspicion of OSA.