Screening for patients at high risk for obstructive sleep apnoea: a community based survey

Purpose: Obstructive Sleep apnoea (OSA), is a major but under recognized clinical entity resulting from repetitive narrowing or collapse of upper airway during sleep. It may be associated with excessive daytime sleepiness(obstructive sleep Apnea syndrome).
We aimed to estimate adult population at risk for OS Ain urban and rural field practice by validated survey instruments.
Methods: In this Community based cross-sectional descriptive study, population in the three slums adjoining Urban health centre and three villages near rural health centres were screened by interns using Epworth Sleepiness scale and Berlin Questionnaire.
Results: Adults (N=308) in the age group 18-60 years were recruited. Out of 308, 239 had no risk,79 had risk of OSA according to Epworth scale and 55 according to Berlin scale.12 subjects with moderate to high scores confirmed by level 1polysomnography with Apnoea Hypopnoea Index ranging from> 5 to ≥30.Occupation, education, exercise, coexisting morbidities, Body mass Index, neck circumference and waist circumference bore statistically significant (p<0.05) relation with these scores.
Conclusion: Obstructive sleep apnea is prevalent in 8-25% of at-risk adult population.Established risk factors are age, snoring, high blood pressure, obesity, diabetes, hyperlipidaemia, metabolic syndrome, and hypothyroidism .Simple questionnaire-based evaluation tools can estimate the risk for OSA. It is very important to evaluate OSA at community level to increase awareness, prevent related morbidity, mortality, encourage healthy lifestyles and initiate necessary treatment in both urban and rural population. Preventive measures if initiated early in the course of disease like evaluation by survey and encouraging healthy life styles can render benefits in mild to moderate OSA.Physicians should be sensitised early so that the disease can be effectively addressed at community level.