Obstructive sleep apnea and related symptoms in medical students

Authors

DOI:

https://doi.org/10.33448/rsd-v11i9.31653

Keywords:

Polysomnography; Student Health; Daytime Sleepiness; Obstructive sleep apnea.

Abstract

Objective: This prospective and cross-sectional study investigated the occurrence of obstructive sleep apnea (OSA) and related symptoms in medical students. Method: Sociodemographic and anthropometric data were collected. The survey included the Epworth sleepiness scale, Berlin questionnaire, STOP-Bang, and NoSAS. Participants underwent overnight digital monitoring of respiratory events (≥ 3% drop in SpO2) using a high-resolution oximeter. Those with high risk for OSA in the Berlin questionnaire or an oxygen desaturation index ≥ 5 to < 15 events/hour, were examined through type 3 polysomnography. Results: The evaluated sample comprised 64 students, aged 22.3±2.3 years, and 38 (59.4%) males. A high risk for OSA frequency was detected in 10.9% of the sample through the Berlin questionnaire, and in 4.7% through STOP-Bang and NoSAS. A mild form of this disorder was diagnosed in 4.7% of the sample through type 4 polysomnography, and in 6.2% using type 3 polysomnography. Excessive daytime sleepiness and being overweight were associated with the occurrence of mild obstructive sleep apnea (p ≤0.05). Males presented higher body mass index values, neck circumference, oxygen desaturation index events/hour, and continuous values in the Berlin questionnaire, STOP-Bang, and NoSAS, than females (p ≤0.05). Conclusion: Despite a low occurrence of the assessed sleep-disordered breathing among medical students, male gender, overweight and sleepiness consisted of factors associated with obstructive sleep apnea, indicating that medical students with this profile should be early and systematically screened for this condition.

References

Aielo, A. N., Santos, R. B., Silva, W. A., Parise, B. K., Souza, S. P., Cunha, L. F., et al. (2019). Pragmatic validation of home portable sleep monitor for diagnosing obstructive sleep apnea in a non-referred population: The ELSA-Brasil study. Sleep Sci, 2, 65-71.

Bhattacharyya, N. (2015). Sleep and health implications of snoring: A populational analysis. Laryngoscope, 125, 2413-2416.

Bertolazi, A. N., Fagondes, S. C., Hoff, L. S., Pedro, V. D., Menna Barreto, S. S., & Johns, M. W. (2009). Portuguese-language version of the Epworth sleepiness scale: validation for use in Brazil. J Bras Pneumol, 35, 877-883.

Collop, N. A., Anderson, W. M., Boehlecke, B., Claman, D., Goldberg, R., Gottlieb, D. J., et al. (2007). Portable Monitoring Task Force of the American Academy of Sleep Medicine. Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med, 3, 737-47.

Drager, L. F., Bortolotto, L. A., Figueiredo, A. C., Krieger, E. M., & Lorenzi, G. F. (2007). Effects of continuous positive airway pressure on early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit Care Med, 176, 706-712.

Drager, L. F., Bortolotto, L. A., Krieger, E. M., & Lorenzi-Filho, G. (2009). Additive effects of obstructive sleep apnea and hypertension on early markers of carotid atherosclerosis. Hypertension, 53, 64-69.

Duarte, R. L. M., Fonseca, L. B. M., Magalhães-da-Silveira, F. J., Silveira, E. A. D., & Rabahi, M. F. (2017). Validation of the STOP-Bang questionnaire as a means of screening for obstructive sleep apnea in adults in Brazil. J Bras Pneumol, 43, 456-463.

Duarte, R. L., Magalhães-da-Silveira, F. J., Oliveira-E-Sá, T. S., Silva, J. A., Mello, F. C., & Gozal, D. (2020). Obstructive sleep apnea screening with a 4-item instrument, named GOAL questionnaire: development, validation and comparative study with No-Apnea, STOP-Bang, and NoSAS. Nat Sci Sleep, 12, 57-67.

Edwards, B. A., Bristow, C., O'Driscoll, D. M., Wong, A. M., Ghazi, L., Davidson, Z. E., et al. (2019). Assessing the impact of diet, exercise and the combination of the two as a treatment for OSA: A systematic review and meta-analysis. Respirology, 24, 740-751.

Herschmann, S., Berger, M., Haba-Rubio, J., & Heinzer, R. (2021). Comparison of NoSAS score with Berlin and STOP-BANG scores for sleep apnea detection in a clinical sample. Sleep Med, 79, 113-116.

Hui, D. S., Chan, J. K., Ho, A. S., Choy, D. K., Lai, C. K., & Leung, R. C. (1999). Prevalence of snoring and sleep-disordered breathing in a student population. Chest, 116, 1530-1536.

Joshipura, K., Muñoz-Torres, F., Vergara, J., Palacios, C., & Pérez, C. M. (2016). Neck circumference may be a better alternative to standard anthropometric measures. J Diabetes Res, 2016, 6058916.

Kapur, V., Blough, D. K., Sandblom, R. E., Hert, R., de Maine, J. B., Sullivan, S. D., et al. (1999). The medical cost of undiagnosed sleep apnea. Sleep, 22, 749-755.

Kapur, V. K., Auckley, D. H., Chowdhuri, S., Kuhlmann, D. C., Mehra, R., Ramar, K., et al. (2017). Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med, 13, 479-504.

Migacz, E., Wichniak, A., & Kukwa, W. (2017). Are questionnaires reliable in diagnosing sleep-disordered breathing in university students? J Laryngol Otol, 131, 965-971.

Nishijima, T., Kizawa, T., Hosokawa, K., Endo, F., Kasai, Y., Yamashiro, Y., et al. (2018). Prevalence of sleep-disordered breathing in Japanese medical students based on type-3 out-of-center sleep test. Sleep Med, 41, 9-14.

Obesity: preventing and managing the global epidemic (2000). Report of a WHO consultation. World Health Organ Tech Rep Ser, 894, 1-253.

Peng, M., Chen, R., Cheng, J., Li, J., Liu, W., & Hong, C. (2018). Application value of the NoSAS score for screening sleep-disordered breathing. J Thorac Dis, 10, 4774-4781.

Peppard, P. E., Young, T., Barnet, J. H., Palta, M., Hagen, E. W., & Hla, K. M. (2013). Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol, 177, 1006-1014.

Pinheiro, G. D. L., Cruz, A. F., Domingues, D. M., Genta, P. R., Drager, L. F., Strollo, P. J., et al. (2020). Validation of an overnight wireless high-resolution oximeter plus cloud-based algorithm for the diagnosis of obstructive sleep apnea. Clinics, 27, e2414.

Rashid, N. H., Zaghi, S., Scapuccin, M., Camacho, M., Certal, V., & Capasso, R. (2021). The value of oxygen desaturation index for diagnosing obstructive sleep apnea: a systematic review. Laryngoscope, 131, 440-447.

Singh, V., Pandey, S., Singh, A., Gupta, R., Prasad, R., & Singh Negi, M. P. (2012). Study pattern of snoring and associated risk factors among medical students. Biosci Trends, 6, 57-62.

Stradling, J. R., Thomas, G., Warley, A. R., Williams, P., & Freeland, D. (1990). Effect of adenotonsillectomy on nocturnal hypoxaemia, sleep disturbance and symptoms in snoring children. Lancet, 335, 249-253.

Tufik, S., Santos-Silva, R., Taddei, J. A., & Bittencourt, L. R. (2010). Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study. Sleep Med, 11, 441-446.

Vaz, A. P., Drummond, M., Mota, P. C., Severo, M., Almeida, J., & Winck, J. C. (2011). Translation of Berlin questionnaire to portuguese language and its application in OSA identification in a sleep disordered breathing clinic. Rev Port Pneumol, 17, 59-65.

Veugen, C. C. A. F. M., Teunissen, E. M., den Otter, L. A. S., Kos, M. P., Stokroos, R. J., & Copper, M. P. Prediction of obstructive sleep apnea: comparative performance of three screening instruments on the apnea-hypopnea index and the oxygen desaturation index. Sleep Breath. 2021;25(3):1267-1275.

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Published

04/07/2022

How to Cite

COSTA, M. P. da .; LORENZI FILHO, G. .; MARZANO RODRIGUES, M. N. .; TRINDADE SUEDAM, I. K. .; TRINDADE, S. H. K. . Obstructive sleep apnea and related symptoms in medical students. Research, Society and Development, [S. l.], v. 11, n. 9, p. e11911931653, 2022. DOI: 10.33448/rsd-v11i9.31653. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/31653. Acesso em: 13 aug. 2022.

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Section

Health Sciences