Turkish Archives of Otorhinolaryngology (Mar 2010)

Relationship between clinical history and physical examination findings and apnea hypopnea index in patients with obstructive sleep apnea syndrome

  • İstemihan Akın,
  • Mustafa Sağıt,
  • Nergis Salman,
  • İbrahim Hikmet Fırat

DOI
https://doi.org/10.2399/tao.09.023
Journal volume & issue
Vol. 48, no. 1
pp. 21 – 27

Abstract

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Objectives: The aim of this study was to investigate the correlation between clinical history, physical examination results and apnea hypopnea index (AHI) in patients with suspected obstructive sleep apnea syndrome (OSAS).Methods: We evaluated 110 patients who admitted to our clinic with a primary complaint of snoring and witnessed apnea. Demographic data including age, sex, body mass index (BMI) and neck circumference were recorded. Patients’ medical history was recorded and all of them completed an Epworth sleepiness scala (ESS) questionnaire. Their flexible fiberoptic nasopharyngoscopy by Muller maneuver and modified Mallampati scores (MMS) were recorded during otorhinolaryngologic evaluation. Then patients underwent overnight polysomnography. The AHI is used to classify the severity of sleep apnea into the following categories: Group 1; an AHI of 0 to 5 indicates that simple snoring, Group 2; an AHI of 5-15 is considered mild sleep apnea, Group 3: an AHI of 15-30 is moderate sleep apnea, Group 4: an AH‹ of >30 is severe sleep apnea. The correlation between BMI, neck circumference, ESS scores, modified Mallampati scores and Muller maneuver results and group categories were investigated.Results: There were statistically significant differences between the groups for neck circumferences, ESS scores and retropalatal narrowing grade in Muller maneuver. There were no statistically significant differences between the groups for BMI, modified Mallampati scores and tongue base narrowing grade in Muller maneuver. There was significant correlation between the AHI and neck circumference, ESS scores, modified Mallampati scores, retropalatal and tongue base narrowing grade in Muller maneuver, however it was found that only ESS score was an independent variable for AHI.Conclusion: When patients who applied to ENT clinics for primary complaint of snoring and witnessed apnea have high ESS scores and high obstruction grades in Muller maneuver, they should be directed sleep laboratory and be prioritized for polysomnographic examination since they may have an increased OSAS risk.

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