A Study on the Clinical Characteristics and Polysomnography of Patients Visited in Snoring and Sleep Apnea Clinic of SNUDH

Abstract

Obstructive sleep apnea (OSA) is defined as a cessation of breathing by repetitive collapse of the upper airway during sleep resulting in excessive daytime sleepiness and cardiovascular disease. The prevalence is growing and there have been ongoing clinical needs for dentists to play an important role in management of OSA. The aims of this study were to evaluate the clinical characteristics and polysomnography data of patients who visited the Seoul National University Dental Hospital (SNUDH) and to suggest guidelines for the management of sleep disordered-breathing patients in a dental clinic. Five hundred sixty-two patients who visited the Snoring and Sleep Apnea Clinic of SNUDH were evaluated for clinical characteristics including associated comorbidities, age, gender, BMI, neck circumference, and daytime sleepiness and among them 217 patients examined by polysomnography were evaluated for respiratory disturbance index (RDI), apnea-hypopnea index (AHI), oxygen saturation levels, and sleep stages. The associations among clinical characteristics, sleep parameters, and positional and REM dependencies of the patients were analyzed. The most common medical comorbidities of the patients were cardiovascular (30.2%), endocrine (10.8%), and respiratory diseases (7.9%). Age (β=0.394), total AHI (β=0.223), and lowest O2 saturation levels (β=0.205) were significantly associated with the number of comorbidities in patients with OSA. Mean O2 saturation was not significantly associated with the number of comorbidities. Non-positional OSA patients had higher BMI, longer neck circumferences, more severe AHI values, and lower mean and lowest O2 saturation levels compared to positional OSA patients. Not-REM-related patients were older and had more severe AHI values compared to REM-related patients. Not-REM-related patients have longer duration of stage I sleep and shorter stage II, III, and REM sleep than REM-related patients. There were no significant differences in each sleep stage between positional and non-positional patients. Neck circumference, positional dependency, REM dependency, and percentage of supine position were significantly associated with severity of OSA. There was no significant difference in total AHI value between Korean and US patients, but Korean patients were younger and had lower BMI and smaller neck circumference than US patients.