PURPOSE: Under-recognition of obstructive sleep apnea (OSA) worsens co-morbid cardiovascular diseases and impairs global quality of life, both cognitive and physical. Hospitalized patients have more severe illness and are at higher risk of OSA. This study aimed to determine: 1) risk of OSA among hospitalized patients; 2) proportion of patients previously asked about symptoms of, or diagnosed with OSA, 3) factors predicting OSA risk; and. 4) relationship between risk of OSA and day-time sleepiness.
METHODS: All adults admitted over a two week period were screened for OSA using the STOP-BANG questionnaire. Daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS).
RESULTS: Of the142 patients (mean age48.4±16.1 years), 80(56.3%) were males. Frequency of diabetes, hypertension and obesity were 19.7%, 35.2% and 16.2% respectively. 56 (39.5%) had high risk of OSA (score≥3). 68.2% at high risk had been asked about sleep disordered breathing compared to 31.8% at low risk (p=0.003) but none had a previous diagnosis of OSA. Age (P<0.0001), day time sleepiness (p=0.003) and neck circumference (p=0.034) were the most significant determinants of high risk. 16(26.7%) patients at high risk of OSA in contrast to 11(12.7%) of low risk had symptoms of day time sleepiness (RR=0.59; 95% confidence interval 0.39-0.88; p=0.02).
CONCLUSIONS: A high proportion of hospitalized patients at our tertiary institution are at high risk of OSA and none has had a formal diagnosis of the condition. About 1/3rd exhibit day time sleepiness compatible with and warranting evaluation for sleep apnea.
CLINICAL IMPLICATIONS: Screening for OSA will identify those at high risk for further evaluation and treatment which will help in improving overall patient care.
DISCLOSURE: The following authors have nothing to disclose: Obianuju Ozoh, Ayesha Akinkugbe, Nkiru Asoegwu, Njideka Okubadejo, Amam Mbakwem, Cyril Chukwu, Emmanuel Bandele
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