The Role of Physical Examination in Patients with Obstructive Sleep Apne Syndrome
Journal Title: Journal of Ankara University Faculty of Medicine - Year 2019, Vol 72, Issue 1
Abstract
Objectives: To correlate the physical examination findings, Epworth Sleepiness Scale (ESS) and apnea-hypopnea index (AHI) in patients investigated for obstructive sleep apnea syndrome (OSAS). Materials and Methods: Patients who are investigated with a nocturnal polysomnography (PSG) for OSAS due to snoring, witnessed apnea, daytime sleepiness symptoms included in this study. Physical examination findings, ESS scores, AHI and minimum oxygen saturations (min: SpO2) were noted. Results: One-hundred-twenty patients were diagnosed; simple snoring (44.2%, n=53), mild OSAS (18.3%, n=22), moderate OSAS (14.2%, n=17) and severe OSAS (23.3%, n=28). We found a positive correlation between body mass index (BMI), neck circumference and AHI (r=0.238, p=0.009; r=0.484, p<0.001 respectively). Neck circumference of severe OSAS patients were significantly higher than simple snoring patients (p=0.006). There was a negative correlation between AHI and min SpO2 (r=-0.666, p<0.001). There was no correlation between AHI, OSAS diagnosis and ESS. There was no correlation between Friedman stages, palate positions and AHI. When the BMI is over 29.3, odds ratio was 3.13 (1.4-6.67) for OSAS diagnosis. Conclusion: Detailed physical examination is essential to patient selection for OSAS investigation and PSG as well as determining the severity of OSAS. BMI and neck circumference should be included in the routine physical examination since they are highly correlated with AHI. Although ESS was not correlated with AHI in our study population, it had helped patients realize their symptoms.
Authors and Affiliations
Selçuk Mülazımoğlu, Hazan Başak, Nurlan İsayev, Süha Beton, Yücel Anadolu
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