High Risk of Obstructive Sleep Apnea Among Hypertensive Patients: A Prevalence Study

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):

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

SLEEP ◽

10.1093/sleep/zsab072.479 ◽

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<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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Perioperative myocardial injury risk after elective knee and hip arthroplasty in patients with a high risk of obstructive sleep apnea

Sleep And Breathing ◽

10.1007/s11325-020-02068-3 ◽

2020 ◽

Author(s):

Steven Lee ◽

AJ Hirsch Allen ◽

Erin Morley ◽

Petrus Swart ◽

William Henderson ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

High Risk ◽

Hip Arthroplasty ◽

Injury Risk ◽

Myocardial Injury ◽

Obstructive Sleep ◽

Knee And Hip Arthroplasty

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Effects of continuous positive airway pressure on blood pressure in hypertensive patients with obstructive sleep apnea

Journal of Hypertension ◽

10.1097/hjh.0b013e32835bdcda ◽

2013 ◽

Vol 31 (2) ◽

pp. 352-360 ◽

Cited By ~ 22

Author(s):

Alexandros Kasiakogias ◽

Costas Tsioufis ◽

Costas Thomopoulos ◽

Dimitrios Aragiannis ◽

Manos Alchanatis ◽

...

Keyword(s):

Blood Pressure ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Continuous Positive Airway Pressure ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Hypertensive Patients ◽

Obstructive Sleep

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Diastolic dysfunction in controlled hypertensive patients with mild–moderate obstructive sleep apnea

International Journal of Cardiology ◽

10.1016/j.ijcard.2015.02.037 ◽

2015 ◽

Vol 187 ◽

pp. 686-692 ◽

Cited By ~ 11

Author(s):

Elisabetta Lisi ◽

Andrea Faini ◽

Grzegorz Bilo ◽

Laura Maria Lonati ◽

Miriam Revera ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Diastolic Dysfunction ◽

Hypertensive Patients ◽

Obstructive Sleep

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Obstructive sleep apnea syndrome and sleep quality in hypertensive patients

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.63.12.1055 ◽

2017 ◽

Vol 63 (12) ◽

pp. 1055-1060 ◽

Cited By ~ 3

Author(s):

Marcelo Rodrigues Bacci ◽

Jonathan Naim Mora Emboz ◽

Beatriz da Costa Aguiar Alves ◽

Glaucia Luciano da Veiga ◽

Neif Murad ◽

...

Keyword(s):

Blood Pressure ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sleep Quality ◽

High Blood Pressure ◽

Antihypertensive Drugs ◽

Poor Sleep ◽

Hypertensive Patients ◽

Group I ◽

Obstructive Sleep

Summary Introduction: Obstructive sleep apnea and hypopnea syndrome (OSAHS) is one of the developmental factors of high blood pressure (HBP), a relevant global public health problem. OSAHS is characterized by the reduction or complete cessation of respiratory airflow due to intermittent airway collapse. Additionally, significant changes in sleep rhythm and pattern are observed in these patients. Objective: To evaluate the association between OSAHS and sleep quality in essential and resistant hypertensives. Method: A cross-sectional, observational study evaluated 43 hypertensive patients treated at the outpatient clinics of the Faculdade de Medicina do ABC (FMABC) who were medicated with two or more antihypertensive drugs and divided into nonresistant or resistant to treatment. Results: Group I (using up to two antihypertensive agents – 60.47% of the sample) presented mean systolic blood pressure (SBP) of 127.5±6.4 mmHg, mean diastolic blood pressure (DBP) of 79.6±5.2 mmHg, mean body mass index (BMI) of 27.2±5.3 kg/m2 and mean age of 51.2±15.1 years. Group II (using more than two antihypertensive drugs – 37.2% of the sample) presented mean SBP of 132.1±9.3 mmHg, mean DBP of 84.5±5.8 mmHg, mean BMI of 27.2±7.2 kg/m2 and mean age of 55.5±13.4 years. The patients presented low quality of sleep/sleep disorder evaluated by the Pittsburgh Sleep Quality Index (PSQI), which represents a preponderant factor for OSAHS. Conclusion: Patients at high risk for OSAHS had poor sleep quality and high levels of DBP, suggesting a causal relation between these parameters. However, they did not present a higher prevalence of resistant high blood pressure (RHBP).

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