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- Title
POLYGRAPHY FOR SLEEP APNEA DIAGNOSIS AND TREATMENT IN PULMONOLOGY CLINIC 2017/2019.
- Authors
Jimborean, Gabriela; Csipor, Alpar; Morar, Daniela; Szathmary, Mioara; Ianosi, Edith Simona
- Abstract
Introduction: Sleep apnea (SA) is a well-known frequent disease with early complications: cardio-vascular diseases, diabetes, dyslipidemia, sexual dysfunction, social isolation, cognitive decline, traffic accidents. Cardiorespiratory poligraphy (PG) is an easy performing investigation for obstructive SA (OSA). PG has to be performed in all patients with risk factors and symptoms for OSA (snoring, obesity, alcohol consume, diurnal somnolence, lack of energy) and above mentioned complications. Purpose and Method: Analyze of the diagnosis by PG in Pulmonology Clinic (2017-2019). Results: 205 patients were investigated by PG in our Sleep Lab consecutively the suspicion of SA. 178(86.8%) were referred by the pulmonologists from other departments, 7(3.4%) by the cardiologists, 3(1.46%) by the neurologists, 8(3.9%) by the general practitioners, 2(0.97%) by the specialists in diabetes, 7(3.4%) by the ENT specialists. Men were predominantly (ratio 6.1:1), with age between 24years-old and 78. BMI average was 36.2kg/m2. We raised suspicion for SA by clinical exam (increased BMI, neck circumference, waist size, snoring, diurnal somnolence, and nocturnal arousals) and Epworth drowsiness scale. SA was confirmed by PG with 6 channels. We found moderate/severe SA in 192 patients (high yield of investigation 93.6%). 188 (97.9%) patients had OSA, 4 central/mixed apnea and 35(18.6%) had also obesity- hypoventilation syndrome. The risk factors for OSA found in our group were: obesity, alcohol abuse, chronic smoking, diabetes, hypothyroidism, sedentary, ENT obstructions (tonsillitis, chronic rhinitis, and polyposis), muscular hypotonia. The average apnea-hypopnea index was 57events/hour. We performed investigations for complications: blood exam (glucose, lipids), endocrinological exam, EKG, cardiovascular consult, respiratory functional tests and chest x-ray. Complications were extremely frequent: 171 patients (89%) - hypertension, cardiac failure, arrhythmia, diabetes, dyslipidemia, depression, cognitive decline, decrease of life quality. After pressures to need titration we recommended a complex treatment: Continuous Positive Airway Pressure, weight loss, cessation of alcohol/sedatives/smoking, increase exercise (for weight loss, metabolism boosting and respiratory muscles reinforcing). Conclusions: SA diagnosis yield from suspected patients was very high based on clinical examination, Epworth scale and PG established the confirmation. PG was accessible, easy to perform with short hospitalization (average 3 days). In the presence of SA risk factors any medical specialists has to referre the patient to the sleep lab for a specific PG during sleep for an early SA diagnosis, treatment and for complication prevention.
- Subjects
SLEEP apnea syndromes; MEDICAL specialties &; specialists; CONTINUOUS positive airway pressure; HYPOVENTILATION; WAIST circumference; DISEASE complications; SNORING
- Publication
Acta Medica Marisiensis, 2019, Vol 65, p5
- ISSN
2068-3324
- Publication type
Article