Predictors for Presence and Severity of Obstructive Sleep Apnea in Snoring Patients: Significance of Neck Circumference
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Objectives: Documented risk factors for obstructive sleep apnea include advanced age, male gender, hypertension, large neck circumference, and obesity; but some controversy remains regarding the risk factors, especially in Asians. In this study, we evaluated the risk factors for obstructive sleep apnea in snoring patients, and also analyzed the risk factors that could predict the severity of obstructive sleep apnea. Methods: The inclusion criteria were patients 1) who visited our hospital with a chief complaint of snoring as witnessed by a sleep partner and 2) who underwent overnight polysomnography. The primary endpoint was the presence of obstructive sleep apnea as a dependent variable. Results: One hundred forty-seven patients met the inclusion criteria. Of the 147 patients, 109 patients were diagnosed with obstructive sleep apnea. Multivariate analysis showed that old age and large neck circumference were significant independent variables for predicting the presence of obstructive sleep apnea, whereas hypertension and large neck circumference were independent variables for predicting the severity of obstructive sleep apnea. Conclusions: We demonstrated that neck circumference can be used to predict the presence as well as the severity of obstructive sleep apnea in snoring Asian patients.
Abstract
Objectives: Documented risk factors for obstructive sleep apnea include advanced age, male gender, hypertension, large neck circumference, and obesity; but some controversy remains regarding the risk factors, especially in Asians. In this study, we evaluated the risk factors for obstructive sleep apnea in snoring patients, and also analyzed the risk factors that could predict the severity of obstructive sleep apnea. Methods: The inclusion criteria were patients 1) who visited our hospital with a chief complaint of snoring as witnessed by a sleep partner and 2) who underwent overnight polysomnography. The primary endpoint was the presence of obstructive sleep apnea as a dependent variable. Results: One hundred forty-seven patients met the inclusion criteria. Of the 147 patients, 109 patients were diagnosed with obstructive sleep apnea. Multivariate analysis showed that old age and large neck circumference were significant independent variables for predicting the presence of obstructive sleep apnea, whereas hypertension and large neck circumference were independent variables for predicting the severity of obstructive sleep apnea. Conclusions: We demonstrated that neck circumference can be used to predict the presence as well as the severity of obstructive sleep apnea in snoring Asian patients.
참고문헌 (33)
- Chung F, "Predictive performance of the STOP-Bang score for identifying obstructive sleep apnea in obese patients", Obes Surg, 23, pp.2050~2057 (2013)
- Og˘retmenog˘lu O, "Body fat composition : a predictive factor for obstructive sleep apnea", Laryngoscope, 115, pp.1493~1498 (2005)
- Vana KD, "Predictive abilities of the STOP-Bang and Epworth Sleepiness Scale in identifying sleep clinic patients at high risk for obstructive sleep apnea", Res Nurs Health, 36, pp.84~94 (2013)
- Farney RJ, "The STOP-Bang equivalent model and prediction of severity of obstructive sleep apnea : relation to polysomnographic measurements of the apnea", hypopnea index, 2011, pp.7, 459~465
- Chung F, "STOP questionnaire : a tool to screen patients for obstructive sleep apnea", Anesthesiology, 108, pp.812~821 (2008)
- Ahbab S, "Neck circumference, metabolic syndrome and obstructive sleep apnea syndrome ; evaluation of possible linkage", Med Sci Monit, 19, pp.111~117 (2013)
- Flemons WW, "Clinical practice. Obstructive sleep apnea", N Engl J Med, 347, pp.498~504 (2002)
- Kawaguchi Y, "Different impacts of neck circumference and visceral obesity on the severity of obstructive sleep apnea syndrome", Obesity (Silver Spring), 19, pp.276~282 (2011)
- Endeshaw Y, "Clinical characteristics of obstructive sleep apnea in community-dwelling older adults", J Am Geriatr Soc, 54, pp.1740~1744 (2006)
- "Pneumonol Alergol Pol", 2008, 313~320
- Peppard PE, "Longitudinal study of moderate weight change and sleep-disordered breathing", JAMA, 284, pp.3015~3021 (2000)
- Musman S, "Evaluation of a prediction model for sleep apnea in patients submitted to polysomnography", J Bras Pneumol, 37, pp.75~84 (2011)
- Dixon JB, "Predicting sleep apnea and excessive day sleepiness in the severely obese : indicators for polysomnography", Chest, 123, pp.1134~1141 (2003)
- Katz I, "Do patients with obstructive sleep apnea have thick necks?", Am Rev Respir Dis, 141(5 Pt 1), pp.1228~1231 (1990)
- Davies RJ, "The relationship between neck circumference, radiographic pharyngeal anatomy, and the obstructive sleep apnoea syndrome", Eur Respir J, 3, pp.509~514 (1990)
- Hoffstein V, "Differences in abdominal and neck circumferences in patients with and without obstructive sleep apnoea", Eur Respir J, 5, pp.377~381 (1992)
- Stradling JR, "Predictors and prevalence of obstructive sleep apnoea and snoring in 1001 middle aged men", Thorax, 46, pp.85~90 (1991)
- Li KK, "Obstructive sleep apnea syndrome: a comparison between Far-East Asian and white men", Laryngoscope, 110(10 Pt 1), pp.1689~1693 (2000)
- Wang J, "Asians have lower body mass index(BMI)but higher percent body fat than do whites : comparisons of anthropometric measurements", Am J Clin Nutr, 60, pp.23~28 (1994)
- Sakakibara H, "Cephalometric abnormalities in non-obese and obese patients with obstructive sleep apnoea", Eur Respir J, 13, pp.403~410 (1999)
- Iber C, "The AASM Manual for the scoring of sleep and associated events: rules, terminology and technical specifications" (2007), American Academy of Sleep Medicine
- American Academy of Sleep Medicine Task Force, "Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research", Sleep, 22, pp.667~689 (1999)
- Ruehland WR, "The new AASM criteria for scoring hypopneas : impact on the apnea hypopnea index", Sleep, 32, pp.150~157 (2009)
- Caples SM, "Obstructive sleep apnea", Ann Intern Med, 142, pp.187~197 (2005)
- Vgontzas AN, "Does obesity play a major role in the pathogenesis of sleep apnoea and its associated manifestations via inflammation, visceral adiposity, and insulin resistance?", Arch Physiol Biochem, 114, pp.211~223 (2008)
- Salome CM, "Physiology of obesity and effects on lung function", J Appl Physiol, 108, pp.206~211 (2010)
- Young T, "Predictors of sleep-disordered breathing in community-dwelling adults : the Sleep Heart Health Study", Arch Intern Med, 162, pp.893~900 (2002)
- Soylu AC, "Obstructive sleep apnea syndrome and anthropometric obesity indexes", Sleep Breath, 16, pp.1151~1158 (2012)
- Villaneuva AT, "Ethnicity and obstructive sleep apnoea", Sleep Med Rev, 9, pp.419~436 (2005)
- Medeiros CA, "Neck circumference, a bedside clinical feature related to mortality of acute ischemic stroke", Rev Assoc Med Bras, 57, pp.559~564 (2011)
- Martins AB, "Physiopathology of obstructive sleep apnea-hypopnea syndrome", J Bras Pneumol, 33, pp.93~100 (2007)
- Hla KM, "Sleep apnea and hypertension. A population-based study", Ann Intern Med, 120, pp.382~388 (1994)
- Wu MJ, "Retropalatal Müller grade is associated with the severity of obstructive sleep apnea in non-obese Asian patients. Retropalatal Müller grade and OSA in non-obese", Sleep Breath, 15, pp.799~807 (2011)