Undiagnosed Risk of Obstructive Sleep Apnea in Obese Individuals in a Primary Health Care Context

Jaime Pimenta Ribeiro, Adão Araújo, Cláudia Vieira, Filipe Vasconcelos, Pedro Marques Pinto, Benedita Seixas, Bruno Cêrca, Isabel Borges

Abstract


Introduction: Obstructive sleep apnea is a clinical entity that is associated with an increase in morbidity and mortality and it is estimated that it is significantly undiagnosed. The objective of this study was to assess the risk of undiagnosed obstructive sleep apneain obese individuals.
Material and Methods: A descriptive and analytical cross-sectional study; the risk of obstructive sleep apnea’s was assessed over a period of 11 months by applying the STOP-Bang questionnaire to all individuals who attended a family health unit who were aged ≥ 18 years and had body mass index of ≥ 30 kg/m2 and who had not yet been diagnosed with obstructive sleep apnea and agreed to participate; the risk of an undiagnosed moderate to severe obstructive sleep apnea was considered for any STOP-Bang score of ≥ 3.
Results: The risk of undiagnosed obstructive sleep apnea was assessed in 888 individuals (59.3% females) with an average age of 59.6 ± 14.68 years and a mean body mass index 33.6 ± 3.43 kg/m2; the mean STOP-Bang score was 3.5 ± 1.74, 70.9% scored ≥ 3; the frequency of all STOP-Bang questionnaire parameters was higher (p < 0.004) within the group with score ≥ 3.
Discussion: The studied population is one of the main strengths, since it is in obese people that the incidence of this disease is higher. There are some limitations related to this sample coming from a single family health unit, as well as the patients’ follow-up being carried out throughout routine appointments for diseases that are closely related with obstructive sleep apnea.
Conclusion: The level of underdiagnosis of obstructive sleep apnea’s in obese individuals can be significantly high and a large proportion of them may have the disease at a moderate to severe stage; Family Physicians can have a very important role in screening and diagnosis.


Keywords


Obesity; Portugal; Primary Health Care; Sleep Apnea, Obstructive/diagnosis; Surveys and Questionnaires



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