A cross-sectional study to assess burden of obstructive sleep apnoea among type 2 diabetic patients attending urban health centre in an urban slum of south India

Abstract

INTRODUCTIONSleep apnoea is characterized by the cessation of airflow during sleep. There are three main types: obstructive, central, and mixed, and Obstructive sleep apnoea (OSA) is the most common. OSA is repetitive episodes of partial (hypopnea) or complete (apnoea) upper airway obstruction during sleep, resulting in a reduction or stoppage of airflow, followed by awakenings from sleep. OSA is a chronic disorder that often requires lifelong care. The signs, symptoms and consequences of OSA are a direct result of derangements that occur due to repetitive collapse of upper airway. OSA is affecting between 2% and 4% of middle aged adult population (3.6% in Indian adult population). It has been documented that OSA is a significant risk factor in the development of other clinical diseases including hypertension, cardiac arrhythmias, myocardial infarction, stroke, decreased cognitive abilities and excessive ABSTRACT Background: Obstructive sleep apnoea (OSA) is repetitive episodes of partial (hypopnea) or complete (apnoea) upper airway obstruction during sleep, resulting in a reduction or stoppage of airflow, followed by awakenings from sleep. Numerous studies, have concretely established relationships between OSA, type 2 diabetes mellitus (T2DM), and obesity. As the obesity epidemic continues in India, the prevalence of OSA and T2DM will increase. Many patients with T2DM have OSA, but unfortunately majority of them don't know it and remain undiagnosed especially in urban slums. OSA must be detected and treated immediately instead of waiting for years to decide whether there is a problem or not. Hence, the present study was done. Objective of the study is to assess the magnitude of OSA among the type 2 diabetic patients attending urban health centre (UHC) of an urban slum. Methods: This was a cross-sectional study done in an UHC of an urban slum in South India. The sample size was 71. After obtaining written informed consent, the data was collected from previously diagnosed T2DM patients attending UHC using a validated structured questionnaire (STOPBANG and ESS) by interview technique. Results: 66.2% of subjects had high risk of OSA (35.2% had intermediate risk and 31.0% had severe risk of OSA). 40.8% had excessive daytime sleepiness, EDS (22.5% of participants had abnormal/severe EDS, 18.3% had moderate EDS). Conclusions: Nearly two third of T2DM patients had high risk of OSA and half of them had EDS, which was not detected earlier during their routine visits to hospitals in urban slum.

To screen for obstructive sleep apnea in patients with type 2 diabetes mellitus and its association with microvascular complications

“…Undi et al [14] 71 This was a cross-sectional study done in an UHC of an urban slum in South India. The data were collected from previously diagnosed T2DM patients attending UHC using a validated structured questionnaire (STOP-BANG and ESS) by interview technique.…”