Clinical Predictors of Obstructive Sleep Apnea

J Korean Neurol Assoc > Volume 23(3); 2005 > Article

Journal of the Korean Neurological Association 2005;23(3): 324-329.

폐쇄성수면무호흡증의 임상적 예측인자들

공혜원, 이훈재a 최윤석b 나정호 하충건 황대웅c 김연옥c 윤창호

인하대학교 의과대학 신경과학교실, 예방사회의학a, 이비인후과b, 메디언스 슬립매니지먼트c

Clinical Predictors of Obstructive Sleep Apnea

Hea-Won Kong

Departments of Neurology, Preventive and Social Medicinea, Otorhinolaryngology and Head and Neck Surgeryb, Inha University College of Medicine, Incheon; Medions Sleep Management Incc, Seoul, Korea

Abstract

Background: Obstructive sleep apnea (OSA) is a common sleep disorder that causes daytime dysfunction and cardiovascular diseases. Nocturnal polysomnography (NPSG) is the standard method of evaluating OSA; however, it is time-consuming, inconvenient, and expensive. Selective performance of NPSG would be possible if we could better predict those who are more likely to have clinically significant OSA. The aim of this study is to define clinical and anthropometric predictors of OSA.
Methods: We included 100 consecutive patients in whom OSA was clinically suspected. Structured sleep interview, anthropometric measurement, and NPSG were performed in all subjects. Presence of OSA was defined when the apnea-hypopnea index was five or more. Parameters from sleep interview and anthropometric data were investigated with multiple logistic regression using the SAS program (ver 8.1, USA) to identify independent predictors of OSA.
Results: OSA was diagnosed in seventy-six patients after NPSG. Univariate analysis showed that the male sex, co-existing diabetes, overweight (BMI≥25), habitual alcohol drinking, large neck circumference (≥40 츠), high waist circumference/hip circumference (WC/HC) ratio (≥0.94), and observed apnea were significantly more frequent in OSA patients (p<0.05). Using multivariate analysis, large neck circumference (≥40 cm) (adjusted OR=4.43, 95% CI: 1.05~18.61) and high WC/HC ratio (adjusted OR=3.48, 95% CI: 1.12~10.80) were found to be the independent predictors of OSA on the NPSG.
Conclusions: We report the predictors of OSA that could be easily identified by clinical and anthropometric evaluations before performing NPSG. This might aid the clinical decision whether or not to perform NPSG in subjects with clinically suspected OSA syndrome. KeyWords:Obstructive sleep apnea, Polysomnography, Waist-Hip Ratio