Emergency department screening for obstructive sleep apnea and obesity hypoventilation syndrome
Leelavathy Jagadeesan, Priya Ganesan, Grace Rebekah, Sivanandan Arul PrakashAbstract
Background:
Obesity remains a critical public health issue worldwide. Respiratory complications such as obstructive sleep apnea (OSA) and obesity hypoventilation syndrome (OHS) significantly impact the quality of life and often go undiagnosed. This study aimed to determine the prevalence of OSA and OHS among obese patients presenting to the emergency department (ED).
Methodology:
A prospective observational study was conducted in the ED of a quaternary care hospital. All patients with a body mass index (BMI) >30 kg/m 2 were enrolled after obtaining informed written consent. Demographic and clinical data, including the STOP-Bang score, Epworth Sleepiness Scale (ESS) score, neck circumference and arterial blood gas, were collected.
Results:
The mean age of the study population was 54 (standard deviation 14.15) years with a female predominance (60%). The prevalence of a significant risk of OSA and OHS was 86.5% and 17.3%, respectively. The most common comorbidities were Type 2 diabetes mellitus (58%) and hypertension (59%). The average BMI was 37 (±6.41), with a mean neck circumference of 41.73 cm (±5.08), mean PaO 2 of 76 mmHg, and mean PaCO 2 of 38 mmHg. Logistic regression analysis showed a significant association of OSA with male sex, diabetes, hypertension, BMI >35 and neck circumference >40 cm. About 27 (17.3%) had daytime PaCO 2 of >45 mmHg, consistent with the OHS definition.
Conclusion:
This study underscores the high burden of undiagnosed OSA and OHS in obese individuals. Early recognition using validated screening tools in the ED can facilitate timely diagnosis and intervention, potentially mitigating the long-term complications associated with these conditions.