397 Health Insurance Status in Subjects at High Risk for Obstructive Sleep Apnea

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A158-A158
Author(s):  
Adnan Abbasi ◽  
Sameepya Thatipelli
Keyword(s):  
Health Care ◽  
Obstructive Sleep Apnea ◽  
Health Insurance ◽  
Sleep Apnea ◽  
High Risk ◽  
Low Risk ◽  
Insurance Status ◽  
Health Insurance Status ◽  
Obstructive Sleep ◽  
Increased Risk

Abstract Introduction Undiagnosed obstructive sleep apnea (OSA) is a major public health problem. Undiagnosed OSA can result in decreased productivity due to absenteeism, increased risk of comorbidities (cardiovascular disease, diabetes, and depression), and increased motor vehicle as well as workplace accidents. Lack of health insurance coverage can lead to undiagnosed and therefore untreated OSA. The objective of this study is to evaluate health insurance status in subjects at high-risk for OSA. Methods This is a cross-sectional, population-based study of adults 18 years and older who participated in the 2017–2018 National Health and Nutrition Examination Survey (NHANES). A modified STOP-Bang score was used to calculate OSA risk. This score included all the variables from the standard STOP-Bang questionnaire, except neck circumference, since it was not reported in the NHANES survey. Subjects were divided into two groups: those at low-risk for OSA with a modified STOP-Bang score of ≤ 3 and those at high-risk for OSA with a modified STOP-Bang score of >4. Results A total of 4,847 adult subjects were included, which represented 223,385,241 of the U.S. non-institutionalized population. Using the modified STOP-Bang score cutoff of >4, 20.9% of the sample were classified as high-risk for OSA, while 79.1% were classified as low-risk for OSA. 90% of the high-risk OSA group and 85.1% of the low-risk OSA group reported having health insurance. Sociodemographic data will also be analyzed and included. Conclusion Approximately 10% of subjects who are at high-risk for OSA reported not having health insurance. This represents over 4.6 million Americans in the non-institutionalized population. Health insurance can improve access to health care. Timely diagnosis and treatment of OSA not only can reduce morbidity and mortality, but can also reduce health care costs. Support (if any) CDC for NHANES Data.

scholarly journals Obstructive Sleep Apnea in General Surgery Patients: Is Screening Required Preoperatively?

2021 ◽  
Vol 5 (3) ◽  
pp. 94-98
Author(s):  
Osama Ahmed ◽  
◽  
Zahid Habib ◽  
Sheeraz Ur Rahman ◽  
Arshad Beg ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
General Surgery ◽  
Risk Group ◽  
Cross Sectional Study ◽  
High Risk Group ◽  
Low Risk ◽  
Cross Sectional ◽  
Obstructive Sleep

Abstract: Aim: To screen cases who are at high risk and low risk for obstructive sleep apnea in general surgery patients. Materials & Methods: It is a cross-sectional study. It was done in Liaquat National Hospital from January 2019 to June 2019. After institutional approval, 335 patients were included in this study, who presented to general surgery OPD. STOP-BANG questionnaire was used to screen cases who are at high risk and low risk for obstructive sleep apnea in general surgery patients. Results: 335 patients were screened and 38.5% of individuals in population had age of more than 50 years. In this population 149(44.5%) of patients were male. Out of 335 patients, 135(40.3%) of them were found to have high risk of obstructive sleep apnea while the remaining 199(59.7%) were classified in low risk group. All of the parameters of STOP-bang questionnaire including age (p<0.001), gender (p=0.026), BMI (p<0.001), snoring (p<0.001), tiredness (p<0.001), sleep apnea (p=0.001), diastolic blood pressure (p<0.001) and neck circumference (p<0.001) were significantly different between high risk and low risk patients. Conclusion: This study can provide a catalyst for more meticulous screening for OSA preoperatively to diagnose high risk group. Keywords: Sleep Apnea, Obstructive, Care, Preoperative, Surgery, General, Operative Procedures.

scholarly journals The Prevalence of High Risk of Obstructive Sleep Apnea and its Association with Sociodemographic Factors among Adults in Taman Dato' Rashid Salleh, Indera Mahkota, Kuantan

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Rawahah Husna Ramli ◽  
Artika Hassan ◽  
Jamalludin Abd Rahman ◽  
Razman Mohd Rus ◽  
Hafizah Pasi ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Demographic Data ◽  
Adult Population ◽  
Neck Circumference ◽  
P Value ◽  
Berlin Questionnaire ◽  
Obstructive Sleep ◽  
Increased Risk

Introduction: Obstructive sleep apnea (OSA) is an insidious sleep breathing disorder, with cardinal manifestations of snoring, witnessed breathing pause during sleep and excessive daytime sleepiness. The aim of the study was to estimate the prevalence of OSA and its associated factors among adult population in Taman Dato’ Rashid Salleh, Kuantan. Materials and  method: A cross-sectional study was carried out among 157 participants who lived in Taman Dato’ Rashid Salleh from May 2018 to June 2018. Obstructive sleep apnea was quantified using the self-administered Malaynvalidated Berlin questionnaire which apart from the demographic data included three categories (10 questions) designed to elicit information regarding snoring (category 1), daytime somnolence (category 2) and the presence of obesity and/or hypertension (category 3). The respondents were considered as high risk of OSA if two or more categories were positive. Weight, height and neck circumference were measured by using Secca© weight scales, Secca© stadiometer and non-elastic plastic tape, respectively. Descriptive statistics was used to measure the prevalence, while chi-square test was used to explore the association of OSA and its background variables. Results: Out of 157 respondents, female and Malay were dominant with the 56.7% and 91.0 %, respectively. The mean age of the respondents was 36.7 (12.2) years old. The prevalence of high risk of OSA in was 18.5%. There was no association between gender, age, race, smoking and neck circumference with risk of OSA while Body Mass Index (BMI) and hypertension were significantly related to an increased risk for developing OSA (p-value < 0.001 and p=0.001, respectively).  Conclusions: Two in every 10 adults in Taman Dato’ Rashid Salleh, Kuantan were at high risk of OSA. It is recommended that appropriate health promotion should be targeted to this community to instill awareness and increase the level of understanding of the public on OSA.

Preeclampsia and Baby Complications Correlated to High-Risk Score for Obstructive Sleep Apnea Screen by STOPBang Questionnaire

2021 ◽  
Vol 104 (6) ◽  
pp. 927-933
Keyword(s):  
At Risk ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Low Risk ◽  
Maternal Complications ◽  
Neonatal Complications ◽  
Obstructive Sleep

Background: Obstructive sleep apnea (OSA) has been postulated as a risk factor for adverse maternal-fetal outcomes, especially preeclampsia. The physiological changes during pregnancy predispose a woman “at risk” towards developing OSA. Therefore, incidence of OSA may increase among pregnant population. STOP-Bang has been postulated as an acceptable screening tool for OSA in obstetric population. Objective: To identify the correlation between preeclampsia and patients who were at risk of OSA, based on STOP-Bang, Berlin, and Epworth sleepiness scale. Materials and Methods: A diagnostic prediction research was conducted using cross-sectional approach. Patients, who have STOP-Bang score of 3 or more and less than 3, were categorized as high-risk and low-risk for OSA, respectively. The relationship between high-risk OSA patients and preeclampsia were evaluated using logistic regression. Results: Seven hundred and three patients were included, and 47 patients (6.7%) were diagnosed preeclampsia. Six hundred fifty and 53 patients were classified as low-risk and high-risk for OSA, respectively. Fifty percent of the high-risk group were complicated with preeclampsia compared with 2.8% in low-risk group. The odd ratio (OR) of having preeclampsia in high-risk group was 32.6 (95% CI 16.1 to 66.1). The pregnant women, classified as high-risk, were associated with neonatal complications by OR 3.4 (95% CI 1.4 to 8.2) but not maternal complications. Conclusion: Among pregnant population, a STOP-Bang score of 3 or more is associated with the occurrence of preeclampsia and neonatal complications. Keywords: STOP-Bang questionnaire; Obstructive sleep apnea; Pregnancy; Preeclampsia

Risk of Postoperative Complications in Patients with Obstructive Sleep Apnea following Skull Base Surgery

2018 ◽  
Vol 158 (6) ◽  
pp. 1140-1147 ◽  
Author(s):  
Phillip Huyett ◽  
Ryan J. Soose ◽  
Amy E. Schell ◽  
Juan C. Fernandez-Miranda ◽  
Paul A. Gardner ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Csf Leak ◽  
Base Population ◽  
Respiratory Events ◽  
Obstructive Sleep ◽  
Increased Risk

Objectives Obstructive sleep apnea (OSA) presents several challenges in skull base surgery, including increased intracranial pressure, worsened OSA with nasal packing, and avoidance of positive airway pressure (PAP) therapy postoperatively. The objective of this study was to examine the risk of postoperative complications in a skull base population with OSA in which PAP therapy is withheld. Study Design Retrospective cohort study. Setting Tertiary care hospital. Subjects and Methods Medical records of 414 adult patients undergoing anterior skull base procedures between January 1, 2014, and January 7, 2017, were retrospectively reviewed. Revision surgeries, skull base infections, sinus surgery, and orbital cases were excluded. Results Fifty-four (13.0%) patients with a diagnosis of OSA were identified. While the known patients with OSA were more likely to require postoperative supplemental oxygen (odds ratio [OR], 4.29; 95% confidence interval [CI], 2.38-7.75; P < .001), there was no increased risk of serious respiratory events or cerebrospinal fluid leak (CSF). To address the likely underdiagnosis of OSA in this cohort, subgroup analyses were performed of patients at high risk for OSA (body mass index >30 kg/m2 and hypertension) and demonstrated an increased risk of serious respiratory events (OR, 4.41; 95% CI, 1.24-15.7; P = .034) and CSF leak (13.6% vs 4.7%; P = .018). Conclusions Skull base patients with known OSA can be successfully managed with diligent care in the perioperative period when PAP therapy is withheld. However, OSA is likely underdiagnosed in the skull base population, and patients at high risk for undiagnosed OSA may be at the greatest risk for respiratory complications and CSF leak. Increased presurgical awareness and implementation of a perioperative management algorithm is needed.

scholarly journals Patients at High Risk for Obstructive Sleep Apnea Are at Increased Risk for Atrial Fibrillation After Cardiac Surgery

2018 ◽  
Vol 126 (6) ◽  
pp. 2025-2031 ◽  
Author(s):  
Nika Karimi ◽  
Marta Kelava ◽  
Perin Kothari ◽  
Nicole M. Zimmerman ◽  
A. Marc Gillinov ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Obstructive Sleep Apnea ◽  
Cardiac Surgery ◽  
Sleep Apnea ◽  
High Risk ◽  
Obstructive Sleep ◽  
Increased Risk

scholarly journals Risk of chronic kidney disease in patients with obstructive sleep apnea

SLEEP ◽  
2021 ◽  
Author(s):  
Andrew E Beaudin ◽  
Jill K Raneri ◽  
Sofia B Ahmed ◽  
A J Marcus Hirsch Allen ◽  
Andrhea Nocon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Kidney Disease ◽  
Ckd Progression ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Very High

Abstract Study Objectives Chronic kidney disease (CKD) is a global health concern and a major risk factor for cardiovascular morbidity and mortality. Obstructive sleep apnea (OSA) may exacerbate this risk by contributing to the development of CKD. This study investigated the prevalence and patient awareness of the risk of CKD progression in individuals with OSA. Methods Adults referred to five Canadian academic sleep centers for suspected OSA completed a questionnaire, a home sleep apnea test or in-lab polysomnography and provided blood and urine samples for measurement of estimated glomerular filtration rate (eGFR) and the albumin:creatinine ratio (ACR), respectively. The risk of CKD progression was estimated from a heat map incorporating both eGFR and ACR. Results 1295 adults (42% female, 54±13y) were categorized based on the oxygen desaturation index (4% desaturation): &lt;15 (no/mild OSA, n=552), 15-30 (moderate OSA, n=322), and &gt;30 (severe OSA, n=421). After stratification, 13.6% of the no/mild OSA group, 28.9% of the moderate OSA group, and 30.9% of the severe OSA group had a moderate-to-very high risk of CKD progression (p&lt;0.001), which was defined as an eGFR &lt; 60 mL/min/1.73m2, an ACR ≥3 mg/mmol, or both. Compared to those with no/mild OSA, the odds ratio for moderate-to-very high risk of CKD progression was 2.63 (95% CI: 1.79-3.85) for moderate OSA and 2.96 (2.04–4.30) for severe OSA after adjustment for CKD risk factors. Among patients at increased risk of CKD progression, 73% were unaware they had abnormal kidney function. Conclusion Patients with moderate and severe OSA have an increased risk of CKD progression independent of other CKD risk factors; most patients are unaware of this increased risk.

Acromegaly and Obstructive Sleep Apnea: Identifying the High-Risk Group

2019 ◽  
Author(s):  
Xiaojun Zhan ◽  
Chandala Chitguppi ◽  
Ethan Berman ◽  
Gurston Nyquist ◽  
Tomas Garzon-Muvdi ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Obstructive Sleep

420 Evaluating the Rate of Referral for Obstructive Sleep Apnea in a Pre-Doctoral Dental Clinic Using the STOP-Bang Questionnaire

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A166-A166
Author(s):  
Nathan Guess ◽  
Henry Fischbach ◽  
Andy Ni ◽  
Allen Firestone
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Electronic Health Record ◽  
Health Record ◽  
Dental Clinic ◽  
Neck Size ◽  
Previous Diagnosis ◽  
Obstructive Sleep ◽  
Electronic Health

Abstract Introduction The STOP-Bang Questionnaire is a validated instrument to assess an individual’s risk for obstructive sleep apnea (OSA). The prevalence of OSA is estimated at 20% in the US with only 20% of those individuals properly diagnosed. Dentists are being asked to screen and refer patients at high risk for OSA for definitive diagnosis and treatment. The aim of this study was to determine whether patients in a dental school student clinic who were identified as high-risk for OSA, were referred for evaluation of OSA. Methods All new patients over the age of 18 admitted to The Ohio State University - College of Dentistry complete an “Adult Medical History Form”. Included in this study were 21,312 patients admitted between July 2017 and March 2020. Data were extracted from the history form to determine the STOP-Bang Score for all patients: age, sex, BMI, self-reported snoring-, stopped breathing/choking/gasping while sleeping-, high blood pressure-, neck size over 17” (males) or 16” (females)-, and tiredness. Each positive response is a point, for a maximum of 8 points possible. Additionally, any previous diagnosis of sleep apnea, and the patient’s history of referrals were extracted from the health record. According to clinic policy, if the patient did not have a previous diagnosis for OSA noted in the health history, and scored 5 or more on the STOP-Bang Questionnaire, they should receive a referral for an evaluation for OSA. Notes and referral forms were reviewed to determine if the appropriate referrals occurred for patients at high risk without a previous diagnosis. Results Of the 21,312 patients screened; 1098 (5.2%) screened high-risk for OSA, of which 398 had no previous diagnosis of OSA. Of these 398 patients, none (0%) had referrals for further evaluation for OSA. Conclusion The rate of appropriate referrals from a student dental clinic with an electronic health record was unacceptably low. Continued education and changes to the electronic health record are needed to ensure those at high-risk for OSA are appropriately referred and managed. Support (if any):

480 Cardiovascular and metabolic risk in patients with suspected comorbid insomnia and obstructive sleep apnea (COMISA)

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A189-A190
Author(s):  
Miguel Meira e Cruz ◽  
Luana Seixas ◽  
Augusto Santos ◽  
João Garrido ◽  
Yuri Lopes ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Arterial Hypertension ◽  
Sleep Time ◽  
Comorbid Condition ◽  
Therapeutic Success ◽  
Comorbid Insomnia ◽  
Systemic Arterial Hypertension ◽  
Obstructive Sleep

Abstract Introduction Only few studies looked for a possible association of cardiovascular disorders (CVD), in comorbid insomnia with obstructive sleep apnea (COMISA) even though this is a relevant topic in order to prevent one of the major causes of morbimortality. The present study aimed to investigate the association of insomnia symptoms in patients at risk for obstructive sleep apnea in terms of prevalence and clinical interactions and to evaluate the risk of CVD in patients with a risk for COMISA. Methods This is a cross-sectional study. All medical records with data such as age, sex, height, weight and BMI, time to sleep, time to wake up, total sleep time, the Epworth Sleepiness Scale (ESS), STOP-BANG Questionnaires were studied. Insomnia and comorbidities were also investigated, and the patientsanswered yes or no to systemic arterial hypertension, diabetes, CVD. Results 685 patients were enrolled on the present study. We observed that the mild, moderate, and high risk for COMISA presented progressively increasing levels for the frequency of hypertension, diabetes, and CVD. A binary logistic regression was performed to assess whether risk for COMISA could be a predictor for CVD, and it was found that the model containing risk for COMISA was statistically significant: [x2(1)=5.273;p&lt;0.021, R2 Negelkerke=0.014]. Risk for COMISA presented itself as a significant predictor for CVD (OR=1.672; 95% CI=1.079–2.592). Conclusion There was an increased frequency of associated comorbidities such as CVD, systemic arterial hypertension, and diabetes, according to the mild, moderate, or high risk. These findings highlight the need for a cardiometabolic evaluation in patients with this comorbid condition which may impact prognosis and therapeutic success. Support (if any):

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