Assessment of severity of sleep apnea in obstructive airway diseases patients at tertiary care hospital

Abstract

Obstructive sleep apnea if remains untreated can lead to excessive daytime sleepiness, diminished performance and overall poor quality of life. Factors that increase vulnerability of sleep apnea include age, male sex, obesity, family history, craniofacial abnormalities and certain health behaviors such as alcohol abuse and smoking. Previously diagnosed cases of COPD and bronchial asthma (as per guidelines) having symptoms of obstructive sleep apnea were also included in this study. This present study was planned to study assessing of severity of sleep apnea in obstructive airway diseases patients.The present study was conducted in sleep laboratory of the Department of Pulmonary Medicine of a tertiary care hospital that caters to population of diverse groups. Patients after clinical examination and spirometry with post bronchodilator reversibility were categorized into bronchial asthma and COPD. Subsequently, polysomnography was done of these patients to study the sleep pattern. Amongst patients with COPD, 11 (16.42%) had mild COPD, 26 (38.80%) had moderate COPD, 22 (32.84%) had severe COPD and 08 (11.94%) patients had very severe COPD. 38.71% and 29.03% that is 12 and 09 out of 31 patients had moderate and severe asthma respectively. Again 19.36% and 12.90% that is 06 and 04 patients had mild persistent and intermittent asthma respectively. 17(25.37%) patients of COPD were found to have obstructive sleep apnea and 09 (29.03%) patients of asthma had obstructive sleep apnea. In patients with overlap syndrome had more severe hypercapnia (mean PaCO 48.88 ±0.017), and nocturnal desaturation (mean 85.35% ±0.022) Patients having moderate COPD had severe OSA. Patients having severe asthma had severe OSA with correlation coefficient R = -0.527 with p value <0.001 meaning negative linear correlation between AHI and % FEV1 of predicted of asthma patients.