Evaluation of patients with suspected obstructive sleep apnea in a low-middle income country: Lagos experience

https://doi.org/10.19106/JMedSci005501202306

Oluwafemi Tunde Ojo(1*), Adeola Olubunmi Ajibare(2), Akinola Olusola Dada(3), Rahmon Moronkola(4), Ayoola Odeyemi(5), Temitope Fapohunda(6), Ikechukwu Adolphus Aganweze(7), Tracy Udoka Ossai(8), Ifeoluwa Owoeye(9), Olufunke Olayinka Adeyeye(10)

(1) Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos/Department of Medicine, College of Medicine, Lagos State University Teaching Hospital, Nigeria
(2) Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos/Department of Medicine, College of Medicine, Lagos State University Teaching Hospital, Nigeria
(3) Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos/Department of Medicine, College of Medicine, Lagos State University Teaching Hospital, Nigeria
(4) Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos.
(5) Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos.
(6) Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos.
(7) Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos.
(8) Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos.
(9) Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos.
(10) Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos/Department of Medicine, College of Medicine, Lagos State University Teaching Hospital, Nigeria
(*) Corresponding Author

Abstract


Obstructive sleep apnea (OSA) is a common chronic disorder that decreases the quality of life of patients. It is an underdiagnosed medical condition in Nigeria. This study aimed to describe the clinical presentations and validate the sleep apnea screening questionnaires with a home sleep study for the diagnosis of patients with suspected OSA seen in Lagos. This was a descriptive cross sectional study carried out on adult patients with suspicion of OSA referred to the Respiratory Clinic of Lagos State University Teaching Hospital. A proforma was used to obtain information and also data from home polysomnography was obtained for each patient. We selected 22 patients. The commonest presentations include snoring (20 or 90.9%), daytime somnolence (16 or 72.7%) and choking while sleeping (12 or 54.5%). The commonest comorbidities were hypertension (16 or 72.7%) and obesity (6 or 27.3%). The STOP-Bang  score identified more patients with a high clinical probability for OSA than the Epworth score (20 and 12 patients respectively). Polysomnography showed evidence of sleep apnea in most suspected patients with severity ranging from mild, to moderate to severe disease (3 or 13.6%, 3 or 13.6%, and 10 or 45.5% respectively). The use of combined Epworth and STOP-Bang questionnaires combination is great tool in identifying patients with suspected cases of OSA based on clinical presentations that will eventually benefit in a resource-limited environment like Lagos. There should be increased awareness of the use of this readily available and cheap questionnaire among physicians in Lagos for ease of OSAS diagnosis for many patients.


Keywords


Obstructive sleep apnea, polysomnography, sleep study, apnea, sleep disordered breathing

Full Text:

PDF


References


1.Kapur VK. Obstructive sleep apnea: diagnosis, epidemiology, and economics. Respir Care 2010; 55(9):1155-67.
2.McNicholas WT. Diagnosis of obstructive sleep apnea in adults. Proc Am Thorac Soc 2008; 5(2):154-60.
https://doi.org/10.1513/pats.200708-118MG
3.Pevernagie DA, Gnidovec‐Strazisar B, Grote L, Heinzer R, McNicholas WT, Penzel T, et al. On the rise and fall of the apnea− hypopnea index: A historical review and critical appraisal. J Sleep Res 2020; 29(4):e13066.
https://doi.org/10.1111/jsr.13066
4.Anonym. Obstructive sleep apnea in adults: epidemiology, clinical presentation, and treatment options. Adv Cardiol 2011; 46:1-42.
https://doi.org/10.1159/000327660
5.Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc 2008; 5(2):136-43.
https://doi.org/10.1513/pats.200709-155MG
6.Chung F, Abdullah HR, Liao P. STOP-Bang questionnaire: a practical approach to screen for obstructive sleep apnea. Chest 2016; 149(3):631-8.
https://doi.org/10.1378/chest.15-0903
7.Johns MW. Sleepiness in different situations measured by the Epworth Sleepiness Scale. Sleep 1994; 17(8):703-10.
https://doi.org/10.1093/sleep/17.8.703
8.Nigro CA, Dibur E, Malnis S, Grandval S, Nogueira F. Validation of ApneaLink Ox™ for the diagnosis of obstructive sleep apnea. Sleep Breath 2013; 17(1):259-66.
https://doi.org/10.1007/s11325-012-0684-4
9.Nigro CA, Dibur E, Aimaretti S, González S, Rhodius E. Comparison of the automatic analysis versus the manual scoring from ApneaLink™ device for the diagnosis of obstructive sleep apnoea syndrome. Sleep Breath 2011; 15(4):679-86.
https://doi.org/10.1007/s11325-010-0421-9
10.Partinen M, Telakivi T. Epidemiology of obstructive sleep apnea syndrome. Sleep 1992; 15(6 Suppl):S1-4.
https://doi.org/10.1093/sleep/15.suppl_6.s1
11.Al Lawati NM, Patel SR, Ayas NT. Epidemiology, risk factors, and consequences of obstructive sleep apnea and short sleep duration. Prog Cardiovasc Dis 2009; 51(4):285-93.
https://doi.org/10.1016/j.pcad.2008.08.001
12.Garvey JF, Pengo MF, Drakatos P, Kent BD. Epidemiological aspects of obstructive sleep apnea. J Thorac Dis 2015; 7(5):920-9.
https://doi.org/10.3978/j.issn.2072-1439.2015.04.52
13.Adewole OO, Hakeem A, Fola A, Anteyi E, Ajuwon Z, Erhabor G. Obstructive sleep apnea among adults in Nigeria. J Natl Med Assoc 2009; 101(7):720-5.
https://doi.org/10.1016/s0027-9684(15)30983-4
14.Desalu O, Onyedum C, Sanya E, Fadare J, Adeoti A, Salawu F, et al. Prevalence, awareness and reporting of symptoms of obstructive sleep apnoea among hospitalized adult patients in Nigeria: a multicenter study. Ethiop J Health Sci 2016; 26(4):321-30.
https://doi.org/10.4314/ejhs.v26i4.4
15.Obstructive sleep apnea in adults: epidemiology, clinical presentation, and treatment options. Adv Cardiol 2011; 46:1-42.
https://doi.org/10.1159/000327660
16.Ohayon MM, Guilleminault C, Priest RG, Caulet M. Snoring and breathing pauses during sleep: telephone interview survey of a United Kingdom population sample. Bmj 1997; 314(7084):860-3.
https://doi.org/10.1136/bmj.314.7084.860
17.Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993; 328(17):1230-5.
https://doi.org/10.1056/NEJM199304293281704
18.Akintunde AA, Salawu AA, Opadijo OG. Assessment of Snoring and obstructive sleep apnoea in a Nigerian university: Association with cardiovascular risk factors. Niger Med J 2014; 55(6):469-73.
https://doi.org/10.4103/0300-1652.144698
19.Lacedonia D, Carpagnano GE, Patricelli G, Carone M, Gallo C, Caccavo I, et al. Prevalence of comorbidities in patients with obstructive sleep apnea syndrome, overlap syndrome and obesity hypoventilation syndrome. Clin Respir J 2018; 12(5):1905-11.
https://doi.org/10.1111/crj.12754
20.Fusetti M, Fioretti AB, Valenti M, Masedu F, Lauriello M, Pagliarella M. Cardiovascular and metabolic comorbidities in patients with obstructive sleep apnoea syndrome. Acta Otorhinolaryngol Ital 2012; 32(5):320-5.
21.Akanbi MO, Agaba PA, Ozoh OB, Ocheke AN, Gimba ZM, Ukoli CO, et al. Obesity and obstructive sleep apnea risk among Nigerians. J Med Trop 2017; 19(2):110-5.
https://doi.org/10.4103/jomt.jomt_17_17
22.Chiu HY, Chen PY, Chuang LP, Chen NH, Tu YK, Hsieh YJ, et al. Diagnostic accuracy of the Berlin questionnaire, STOP-BANG, STOP, and Epworth Sleepiness Scale in detecting obstructive sleep apnea: A bivariate meta-analysis. Sleep Med Rev 2017; 36:57-70.
https://doi.org/ 10.1016/j.smrv.2016.10.004
23.Amra B, Javani M, Soltaninejad F, Penzel T, Fietze I, Schoebel C, et al. Comparison of Berlin Questionnaire, STOP-Bang, and Epworth sleepiness scale for diagnosing obstructive sleep apnea in Persian patients. Int J Prev Med 2018; 9:28.
https://doi.org/10.4103/ijpvm.IJPVM_131_17
24.Vana KD, Silva GE, Goldberg R. Predictive abilities of the STOP-Bang and Epworth Sleepiness Scale in identifying sleep clinic patients at high risk for obstructive sleep apnea. Res Nurs Health 2013; 36(1):84-94.
https://doi.org/10.1002/nur.21512
25.Portier F, Portmann A, Czernichow P, Vascaut L, Devin E, Benhamou D, et al. Evaluation of Home versus Laboratory Polysomnography in the Diagnosis of Sleep Apnea Syndrome. Am J Respir Crit Care Med 2000; 162(3 Pt 1):814-8.
https://doi.org/10.1164/ajrccm.162.3.9908002
26.Zou D, Grote L, Peker Y, Lindblad U, Hedner J. Validation a portable monitoring device for sleep apnea diagnosis in a population based cohort using synchronized home polysomnography. Sleep 2006; 29(3):367-74.
https://doi.org/10.1093/sleep/29.3.367
27.Su S, Baroody FM, Kohrman M, Suskind D. A comparison of polysomnography and a portable home sleep study in the diagnosis of obstructive sleep apnea syndrome. Otolaryngol Head Neck Surg 2004; 131(6):844-50.
https://doi.org/10.1016/j.otohns.2004.07.014
28.Bilgin C, Erkorkmaz U, Ucar MK, Akin N, Nalbant A, Annakkaya AN. Use of a portable monitoring device (Somnocheck Micro) for the investigation and diagnosis of obstructive sleep apnoea in comparison with polysomnography. Pak J Med Sci 2016; 32(2):471-5.
https://doi.org/10.12669/pjms.322.9561



DOI: https://doi.org/10.19106/JMedSci005501202306

Article Metrics

Abstract views : 502 | views : 662




Copyright (c) 2023 Oluwafemi Tunde Ojo, Adeola Olubunmi Ajibare, Akinola Olusola Dada, Rahmon Moronkola, Ayoola Odeyemi, Temitope Fapohunda, Ikechukwu Adolphus Aganweze, Tracy Udoka Ossai, Ifeoluwa Owoeye, Olufunke

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

View My Stats

 

Creative Commons License
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) by  Universitas Gadjah Mada is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Based on a work at http://jurnal.ugm.ac.id/bik/.https://jh.unimed.ac.id/conference/docs/bonusx/ https://jh.unimed.ac.id/conference/docs/demox/ https://jh.unimed.ac.id/conference/docs/max/ https://jh.unimed.ac.id/conference/docs/pulsax/ https://jurnal.uinsu.ac.id/public/bonusx/ https://jurnal.uinsu.ac.id/public/demox/ https://jurnal.uinsu.ac.id/public/pulsax/ https://jurnal.uinsu.ac.id/public/qris/ https://journal.uny.ac.id/lib/demox/ https://journal.uny.ac.id/lib/max/ https://journal.uny.ac.id/lib/thaix/ https://journal.uny.ac.id/lib/gacorx/ https://celebica.uho.ac.id/styles/bonus/ https://celebica.uho.ac.id/styles/demo/ https://celebica.uho.ac.id/styles/gacor/ https://celebica.uho.ac.id/styles/thai/ https://icopis.untad.ac.id/wp-admin/js/xmax/ https://icopis.untad.ac.id/wp-admin/js/thai/ https://icopis.untad.ac.id/wp-admin/js/xgacor/ https://icopis.untad.ac.id/wp-admin/js/xdemo/ https://society.fisip.ubb.ac.id/config/xgacorx/ https://society.fisip.ubb.ac.id/config/xbonusx/ https://society.fisip.ubb.ac.id/config/xpulsax/ https://society.fisip.ubb.ac.id/config/xthai/ https://jurnal.unimed.ac.id/2012/xthai/ https://jurnal.unimed.ac.id/2012/xdemo/ https://jurnal.unimed.ac.id/2012/xgacor/ https://jurnal.unimed.ac.id/2012/xmax/ https://ihdnpress.ihdn.ac.id/wp-content/xgacor/ https://ihdnpress.ihdn.ac.id/wp-content/xpulsa/ https://ihdnpress.ihdn.ac.id/wp-content/xmax/ https://ihdnpress.ihdn.ac.id/wp-content/xthai/ https://jurnaltarbiyah.uinsu.ac.id/cache/bandar-s/ https://jurnaltarbiyah.uinsu.ac.id/cache/demo/ https://jurnaltarbiyah.uinsu.ac.id/cache/max/ https://jurnaltarbiyah.uinsu.ac.id/cache/bonus/ https://jurnal.unmer.ac.id/cache/thaix/ https://jurnal.unmer.ac.id/cache/bonusx/ https://jurnal.unmer.ac.id/cache/demox/ https://jurnal.unmer.ac.id/cache/max/ https://eoffice.uki.ac.id/upload/watermark/ https://student.binus.ac.id/wp-content/uploads/2024/00/1/ https://student.binus.ac.id/wp-content/uploads/2024/00/2/ https://myic.feb.unsoed.ac.id/wp-content/xbandart/ https://myic.feb.unsoed.ac.id/wp-content/xbonus/ https://myic.feb.unsoed.ac.id/wp-content/xpulsa/ https://myic.feb.unsoed.ac.id/wp-content/xtoto/ http://situr.feb.unsoed.ac.id/img/x777/ http://situr.feb.unsoed.ac.id/img/xbonus/ http://situr.feb.unsoed.ac.id/img/xdemo/ http://situr.feb.unsoed.ac.id/img/xtotos/ https://jurnal.staisumatera-medan.ac.id/thaix/ https://jurnal.staisumatera-medan.ac.id/totos/ https://jurnal.staisumatera-medan.ac.id/gacorx/ https://jurnal.staisumatera-medan.ac.id/bandars https://jurnal.fkip.unila.ac.id/sbonus/ https://jurnal.fkip.unila.ac.id/sgacor/ https://jurnal.fkip.unila.ac.id/spulsa/ https://jurnal.fkip.unila.ac.id/sthai/ http://ujian.bebras.polinema.ac.id/images/777/ http://ujian.bebras.polinema.ac.id/images/gacor/ http://ujian.bebras.polinema.ac.id/images/demo/ http://ujian.bebras.polinema.ac.id/images/thai/ https://jesr.eng.unila.ac.id/xgacor/ https://jesr.eng.unila.ac.id/xdemo/ https://jesr.eng.unila.ac.id/xthai/ https://jesr.eng.unila.ac.id/xmax/ http://digilib.fe.unj.ac.id/demo/ http://digilib.fe.unj.ac.id/bonus/ http://digilib.fe.unj.ac.id/pulsa/ http://digilib.fe.unj.ac.id/max/ https://jurnalmiqotojs.uinsu.ac.id/public/777/ https://jurnalmiqotojs.uinsu.ac.id/public/bonus/ https://jurnalmiqotojs.uinsu.ac.id/cache/demo/ http://jristam.uho.ac.id/styles/bonusx/ http://jristam.uho.ac.id/styles/demox/ http://jristam.uho.ac.id/styles/pulsax/ http://jristam.uho.ac.id/styles/thaix/ https://jurnalnasional.ump.ac.id/js/bonusx/ https://jurnalnasional.ump.ac.id/js/demox/ https://jurnalnasional.ump.ac.id/js/kambox/ https://fisip.ubb.ac.id/student/xkambo/ https://fisip.ubb.ac.id/student/xpulsa/ https://fisip.ubb.ac.id/student/xqris/ https://fisip.ubb.ac.id/student/xmax/ http://pub.unj.ac.id/docs/kambo/ http://pub.unj.ac.id/docs/demo/ http://pub.unj.ac.id/docs/max/ http://pub.unj.ac.id/docs/thai/ http://edm.fk.hangtuah.ac.id/public/bonus/ http://edm.fk.hangtuah.ac.id/public/demo/ http://edm.fk.hangtuah.ac.id/public/qris/ http://edm.fk.hangtuah.ac.id/public/totos/ https://endemis-journal.uho.ac.id/tools/zeusx/ https://endemis-journal.uho.ac.id/tools/ovox/ https://endemis-journal.uho.ac.id/tools/mahjongx/ https://endemis-journal.uho.ac.id/tools/qrisx/ https://ejournalagribisnis.uho.ac.id/styles/demox/ https://ejournalagribisnis.uho.ac.id/styles/gacorx/ https://ejournalagribisnis.uho.ac.id/styles/kambox/ https://ejournalagribisnis.uho.ac.id/styles/max/ https://portal.lomboktimurkab.go.id/demo/ https://portal.lomboktimurkab.go.id/gacor/ https://portal.lomboktimurkab.go.id/pulsa/ https://portal.lomboktimurkab.go.id/kambo/ https://websheffield.com/ https://skandinavskikutak.org/ https://andygolledgemusic.com/ https://servicewritingessay.net/ https://timelapsesf.com/ https://aaa-replica.com/ https://eztvshows.com/ https://everchicdesigns.com/ https://moviezucchinis.com/ https://concretecompanywestminsterco.com/ https://seasonalentertainmentllc.com/ https://emarket-solutions.com/ https://cruthucreative.com/ https://rmsinternationalschool.com/ https://redseasquall.com/ https://newstarhotelhanoi.com/