This research revealed a strong relation between apnea- hypopnea index (AHI), average blood oxygen saturation (avSpO2) measured with the pulse oximeter, oxygen desaturation index (ODI) and glycosylated hemoglobin (HbA1c) in obstructive sleep apnea (OSA) patients, not previously diagnosed with diabetes. Data from biochemistry, fundamental biology and previous clinical monitoring reports were integrated in interpreting this relation. The analysis concluded that high levels of HbA1c limit the relevance of avSpO2 in evaluating OSA severity. ODI maintains a strong association with AHI in high levels HbA1c group.

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In patients with obstructive sleep apnoea (OSA), a consequence of the intermittent hypoxia is nocturia. The frequency of nocturia related OSA is increased because many pathological pathways are present simultaneously. The aim was to assess the prevalence of nocturia among OSA patients and to identify the relationship with OSA and its comorbidities. A transversal study determining the prevalence of OSA�s comorbidities and nocturia related OSA and smoking was assessed, from 2011 to 2015, in 2 Romanian centres of Somnology, in Constanta county. All patients suspected of sleep breathing disorders were investigated by polygraphy and all patients diagnosed with OSA were recruited. Demographic and clinical characteristics were assessed, including the onset of nocturia. The comparison between groups with and without nocturia was performed using SPSS software, using Anova for numerical outcomes and c2 test for the categorical ones. Nocturia was highly prevalent (62.75 %) among 204 OSA patients, especially in elderly (p [ 0.00001). High blood pressure (hypertension), obstructive pulmonary disease (COPD), smoking exposure were more frequently reported in the OSA patients presenting nocturia (p[0.05). Type 2 diabetes and cardiac failure were also frequent, but did not reach a significant threshold of 95%. In conclusion, the nocturia is a frequent symptom and it is influenced by the OSA severity and comorbidities as hypertension and COPD. A further multidisciplinary approach in these patients is justified, especially in smokers.

Over the last thirty years, the pathogenesis of obstructive sleep apnea syndrome (OSAS) has begun to be elucidated worldwide due to the presence of standardized diagnostic and treatment. In adults, the clinical diagnosis may be suggestive of OSAS when symptoms like fatigue, lack of concentration, poor work performance, absenteeism, daytime sleepiness, insomnia, snoring, nocturnal respiratory distress or apnea episodes witnessed by others are present. Some medical conditions found in employees’ personal history such as craniofacial abnormalities, some endocrine diseases, arterial hypertension, especially resistant arterial hypertension, coronary artery disease, atrial fibrillation, congestive heart failure, stroke, obesity, diabetes mellitus, cognitive dysfunction or mental disorders may be the alarm signal for OSAS. The assessment of all risk factors, clinical presentation and diagnosis must become an important part of occupational medical examinations and performed in all workers due to its major public health potential and impact on survival. The early identification of OSAS among workers performed by the occupational physician can potentially reduce the risk of work injuries and fatalities. In conclusion, OSAS is a complex entity and an important public health problem. The delay in diagnosis and treatment contributes to the increase of healthcare services demand and implicitly to general mortality.

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