Previously, Andrew blogged about a Japanese study that looked at the effectiveness of a screening tool for OSA. This screening tool compared patients BP, gender, BMI and presence or absence of snoring (these results were then scored) and their AHI (apnoea hyponea index) to determine if there was a correlation and if so a what point. A verified screening tool would be a signifcant break through and it is something we are interested in examining in our population group.
Recently, a Romainian study looked at an OSA screening tool for patients with Type II diabetes and a BMI greater than 30. There were 80 patients in this study. The researchers then assessed the patients Epworth Sleepiness Scale (ESS). The ESS is a questionnaire the patient answers about how likely they would doze off or fall asleep in a variety of situations. A score is derived from these answers. Clinically a score of 13 or above is deemed significant but in this project the researchers referred all patients with a score greater than 10 to have a overnight sleep study. This amounted to 20% of the population group and of these ALL were diagnosed with obstructive sleep apnoea. Of these 33.3% had moderate OSA (AHI = 15-30 events/h of sleep), and 58.3% had severe OSA (AHI >/=30 events/h of sleep). The researchers claimed 'prevalence of OSA in the sampled population was high'. This is true but it would have been interesting to know how many patients missed being diagnosed because they scored under 10 on the ESS.
Anecdotal evidence within our practice demonstrates there are many patients with very low levels of self reported daytime tiredness (e.g a low ESS) who are diagnosed with obstructive sleep apnoea.
Jessica
No comments:
Post a Comment