Association of Excessive Daytime Sleepiness and Obesity with Apnea-Hypopnea Index in Adult Patients Suspected of Obstructive Sleep Apnea Syndrome

Objective: To determine whether excessive daytime sleepiness (EDS) as assessed by the Epworth Sleepiness Scale (ESS) is significantly correlated with body mass index (BMI) and Apnea-Hypopnea Index (AHI) in patients suspected of OSAS and whether obesity as assessed by BMI is associated with AHI....

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Main Authors: Nikki Lorraine Y. King-Chao, Michael A. Sarte
Format: Article
Language:English
Published: Philippine Society of Otolaryngology-Head and Neck Surgery, Inc. 2015-06-01
Series:Philippine Journal of Otolaryngology Head and Neck Surgery
Subjects:
Online Access:https://pjohns.pso-hns.org/index.php/pjohns/article/view/375
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spelling doaj-3d4e9eed48234c3cb9e61254e3d0c0362020-11-25T01:49:18ZengPhilippine Society of Otolaryngology-Head and Neck Surgery, Inc.Philippine Journal of Otolaryngology Head and Neck Surgery1908-48892094-15012015-06-0130110.32412/pjohns.v30i1.375Association of Excessive Daytime Sleepiness and Obesity with Apnea-Hypopnea Index in Adult Patients Suspected of Obstructive Sleep Apnea SyndromeNikki Lorraine Y. King-Chao0Michael A. Sarte1Department of Otorhinolaryngology Head and Neck Surgery The Medical City Ortigas Ave., Pasig City, PhilippinesDepartment of Otorhinolaryngology Head and Neck Surgery The Medical City Ortigas Ave., Pasig City, Philippines; Department of Otorhinolaryngology Head and Neck Surgery Rizal Medical Center Pasig Blvd., Pasig City, Philippines Objective: To determine whether excessive daytime sleepiness (EDS) as assessed by the Epworth Sleepiness Scale (ESS) is significantly correlated with body mass index (BMI) and Apnea-Hypopnea Index (AHI) in patients suspected of OSAS and whether obesity as assessed by BMI is associated with AHI. Methods: Study Design:            Non-Concurrent Cohort Study Setting:                       Tertiary Private Hospital Population:                The charts of 389 patients suspected to have sleep disorders and referred for polysomnography (PSG) at the Center for Snoring and Sleep Disorders in year 2009 were reviewed. Inclusion criteria were patients aged 19 and above with complete data. A total of 238 patient charts were included in the study. Results:The study included a total of 238 patient charts. Results showed no significant association between ESS and AHI (p-value >0.05), even when correlated with the different severities of OSAS (p-value>0.05). Sensitivity and specificity of ESS was found to be 54% and 57%, respectively, indicating that ESS is not a sensitive and specific tool to predict the presence of OSAS. These findings suggest that ESS may not be able to significantly identify patients with OSAS. However, BMI showed a significant association with ESS (p-value<0.05), representing more patients with EDS belonging to the obese category. Conversely, obese patients were twice more likely to have EDS, represented by ESS scores of ³10. BMI wasalso significantly associated with AHI using one-way Anova test. Conclusion: This report concludes that the ESS alone is insufficient to identify patients with OSAS. Nevertheless, questionnaires like the ESS supplement relevant history to help diagnose patients with sleep disorders, particularly OSAS. On the other hand, the ESS showed a significant association with BMI, representing more obese patients had excessive daytime sleepiness. The likelihood ratio of having excessive daytime sleepiness is 2 times more for obese patients. BMI was also significantly associated with AHI, which confirms the well established relationship of obesity with OSAS, and shows that obese patients are at higher risk for severe OSAS. Keywords:obstructive sleep apnea syndrome, daytime sleepiness, Epworth sleepiness scale, polysomnography, apnea-hypopnea index,  body-mass index. https://pjohns.pso-hns.org/index.php/pjohns/article/view/375obstructive sleep apnea syndrome, daytime sleepiness, Epworth sleepiness scale, polysomnography, apnea-hypopnea index, body-mass index
collection DOAJ
language English
format Article
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author Nikki Lorraine Y. King-Chao
Michael A. Sarte
spellingShingle Nikki Lorraine Y. King-Chao
Michael A. Sarte
Association of Excessive Daytime Sleepiness and Obesity with Apnea-Hypopnea Index in Adult Patients Suspected of Obstructive Sleep Apnea Syndrome
Philippine Journal of Otolaryngology Head and Neck Surgery
obstructive sleep apnea syndrome, daytime sleepiness, Epworth sleepiness scale, polysomnography, apnea-hypopnea index, body-mass index
author_facet Nikki Lorraine Y. King-Chao
Michael A. Sarte
author_sort Nikki Lorraine Y. King-Chao
title Association of Excessive Daytime Sleepiness and Obesity with Apnea-Hypopnea Index in Adult Patients Suspected of Obstructive Sleep Apnea Syndrome
title_short Association of Excessive Daytime Sleepiness and Obesity with Apnea-Hypopnea Index in Adult Patients Suspected of Obstructive Sleep Apnea Syndrome
title_full Association of Excessive Daytime Sleepiness and Obesity with Apnea-Hypopnea Index in Adult Patients Suspected of Obstructive Sleep Apnea Syndrome
title_fullStr Association of Excessive Daytime Sleepiness and Obesity with Apnea-Hypopnea Index in Adult Patients Suspected of Obstructive Sleep Apnea Syndrome
title_full_unstemmed Association of Excessive Daytime Sleepiness and Obesity with Apnea-Hypopnea Index in Adult Patients Suspected of Obstructive Sleep Apnea Syndrome
title_sort association of excessive daytime sleepiness and obesity with apnea-hypopnea index in adult patients suspected of obstructive sleep apnea syndrome
publisher Philippine Society of Otolaryngology-Head and Neck Surgery, Inc.
series Philippine Journal of Otolaryngology Head and Neck Surgery
issn 1908-4889
2094-1501
publishDate 2015-06-01
description Objective: To determine whether excessive daytime sleepiness (EDS) as assessed by the Epworth Sleepiness Scale (ESS) is significantly correlated with body mass index (BMI) and Apnea-Hypopnea Index (AHI) in patients suspected of OSAS and whether obesity as assessed by BMI is associated with AHI. Methods: Study Design:            Non-Concurrent Cohort Study Setting:                       Tertiary Private Hospital Population:                The charts of 389 patients suspected to have sleep disorders and referred for polysomnography (PSG) at the Center for Snoring and Sleep Disorders in year 2009 were reviewed. Inclusion criteria were patients aged 19 and above with complete data. A total of 238 patient charts were included in the study. Results:The study included a total of 238 patient charts. Results showed no significant association between ESS and AHI (p-value >0.05), even when correlated with the different severities of OSAS (p-value>0.05). Sensitivity and specificity of ESS was found to be 54% and 57%, respectively, indicating that ESS is not a sensitive and specific tool to predict the presence of OSAS. These findings suggest that ESS may not be able to significantly identify patients with OSAS. However, BMI showed a significant association with ESS (p-value<0.05), representing more patients with EDS belonging to the obese category. Conversely, obese patients were twice more likely to have EDS, represented by ESS scores of ³10. BMI wasalso significantly associated with AHI using one-way Anova test. Conclusion: This report concludes that the ESS alone is insufficient to identify patients with OSAS. Nevertheless, questionnaires like the ESS supplement relevant history to help diagnose patients with sleep disorders, particularly OSAS. On the other hand, the ESS showed a significant association with BMI, representing more obese patients had excessive daytime sleepiness. The likelihood ratio of having excessive daytime sleepiness is 2 times more for obese patients. BMI was also significantly associated with AHI, which confirms the well established relationship of obesity with OSAS, and shows that obese patients are at higher risk for severe OSAS. Keywords:obstructive sleep apnea syndrome, daytime sleepiness, Epworth sleepiness scale, polysomnography, apnea-hypopnea index,  body-mass index.
topic obstructive sleep apnea syndrome, daytime sleepiness, Epworth sleepiness scale, polysomnography, apnea-hypopnea index, body-mass index
url https://pjohns.pso-hns.org/index.php/pjohns/article/view/375
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