VALUE OF THE CLINICAL AND ANTHROPOMETRIC PREDICTORS AND MELATONIN IN THE DIAGNOSIS OF THE OBSTRUCTIVE SLEEP APNEA SYNDROME IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE

Abstract

The purpose of this study was to determine the significance of clinical, anthropometric indicators and determine the level of melatonin and the intensity of expression of its receptors in the esophageal mucosa in predicting obstructive sleep apnea (OSA) in patients with gastroesophageal reflux disease and to develop a diagnostic algorithm for selecting patients for polysomnography (PSG). Material and methods. The study included 182 people (115 men and 67 women; the average age was 46.8±9.1 years). Diagnosis of OSA was made by means of respiratory polygraphy with registration of snoring, air flow through the nose, saturation and pulse. OSA was defined when the index of apnea / hypopnea (AHI) was ≥5. The presence of characteristic symptoms of obstructive sleep apnea was identified by a special questionnaire. The level of 6-sulfatoxymelatonin in the urine was determined. The intensity of expression of melatonin receptors of the second type in the esophageal mucosa was evaluated. The results of the study showed that anthropometric and clinical predictors play an important role in predicting OSA, however, their significance is variable in different clinical populations of patients. The proposed diagnostic algorithm, which combines anthropometric, clinical and laboratory indicators that are statistically significant in forecasting, enables to identify patients who need PSG with high accuracy.

Keywords

• obstructive sleep apnea syndrome
• gastroesophageal reflux disease
• melatonin
• 6-sulfatoxymelatonin
• melatonin receptor
• mt2-receptor
• diagnostic algorithm