Computer Algorithms in Assessment of Obstructive Sleep Apnoea Syndrome and Its Application in Estimating Prevalence of Sleep Related Disorders in Population

Abstract

The incorporation of telemedicine and artificial intelligence for early screening and assessment of severity of life-style disorders has a great potential for better assessment in a busy outpatient clinic and thereby curtail down the related morbidities. A computer based algorithm based upon standardized questionnaire (from established assessment tools) is designed to assess the risk of obstructive sleep apnoea syndrome (OSAS). In addition the incorporation of basic screening questions of anamnesis help in suggesting a probable diagnosis of sleep related disorder as well. The overall data at our center has been analyzed to establish the existing pattern of sleep related disorders. Of 850 healthy subjects screened, prevalence of snoring was 20.47% while OSAS was seen in 4.20% (N = 25) in males and 2.64% (N = 8) in females. The parasomnia was most prevalent (14.71%), followed by insomnia (10.24%), periodic leg movement (6.59%), bruxism (1.65%) and narcolepsy (0.59%). Hypertension, laryngopharyngeal reflux and obesity were the common comorbidities in OSAS while family history of hypertension and diabetes were common in snorers. A significant association with OSA was seen with diabetes mellitus, neck circumference and nasal obstruction, while, obesity and apnoeic episodes were more significantly associated with OSA than snorers. Increased waist to hip ratio was appreciated in both the OSAS and snorers. The algorithm based online assessment is likely to diagnose the occult clinical cases as well as assess the risk of OSAS. In routine outpatient clinic, a clinician may better assess the patient morbidity with a comprehensive availability of symptoms and moreover enhance the post-treatment compliance. In addition a smartphone based computerized assessment for general population may be designed for other lifestyle disorders as well.

Systematic Review of Prevalence of Sleep Problems in India: A Wake- up Call for Promotion of Sleep Health

“…Data also exists about its prevalence in general population. Methods employed ranged from questionnaires 5,6,8–10,12–14,16,18–21,24,25,29–32,34,38–40,42,44,47,48,51,52,55,56,59,60,63,64,67,70–75,80,82,84,87,88,90–97,99–104 , home testing to overnight sleep studies 34,49,51,52,55,58–66,68,69,98,99 . In some studies, screening using questionnaires was done followed by polysomnography 10,26,48,51,52,59,64,99 .…”

“…Some were done on caregivers and attendants 9,10,97 of patients while they were in hospital or attending on a patient while in outpatient department. Few studies worked on general population using representative samples of college students 13,14,35,42,80,92,104 and some targeted the population in general 12,16,37,38,40,67,78,79,81,93,94 .…”

Enhancing India’s Health Care during COVID Era: Role of Artificial Intelligence and Algorithms

“…The incorporation of the questionnaire based algorithms have a very important role in short listing differential diagnoses. With encouraging results obtained during a study at the departments of Pulmonary medicine and Otolaryngology using ABA (algorithm based assessment) [ 4 ], it is feasible to extend this concept to every specialty of medicine. The likely advantages of ABA are many: (1) The ABA is likely to record a comprehensive registry of complaints, then siphon out the irrelevant information/complaints while presenting the primary concern/relevant symptomatology to the treating physician; thereby making effective use of the allotted limited time; (2) It may be standardized or customized as per the situation/disease/specialty and then adopted widely to maintain a minimum standard of assessment; (3) The patients can be encouraged to fill in the questionnaires at home through online portal and accordingly may be referred to specialty clinic depending upon the focus of specific ailment; (4) Online ABA at home may screen and unexpectedly reveal some occult set of problems; (5) ABA may even assist the educated-non-medical persons residing in remote areas (absence of physician) to understand the gravity of ailment and thereby facilitate urgent consultation if needed; (7) it may be an asset for the patients to follow up their post-treatment recovery as well; (8) the social distancing will be maintained up to a certain extent at least further contributing to the corona control.…”