Screening Patients with Type 2 Diabetes at High Risk of Obstructive Sleep Apnea: A Single Tertiary Center Experience

Year 2024, Volume: 8 Issue: 2, 127 - 134, 30.08.2024

Tuğba Barlas , Hande Özkılıçaslan , Bengisu Çinici , Mehmet Muhittin Yalçın , Mujde Akturk , Füsun Baloş Törüner , Ayhan Karakoc , Alev Eroğlu Altınova

https://doi.org/10.25048/tudod.1485671

Abstract

Objective: Current guidelines suggest screening patients with type 2 diabetes (T2D) for obstructive sleep apnea (OSA). However, there is no consensus regarding the optimal method for OSA risk assessment. We aimed to identify those with diabetes who are at high risk for OSA and investigate the concordance among questionnaires utilized in assessing high OSA risk.
Method: STOP, STOP-BANG, and Berlin questionnaires for the assessment of the risk of OSA and the Epworth Sleepiness Scale (ESS) for an investigation of daytime sleepiness were utilized.
Results: We included 108 patients, with a median HbA1c of 7.5%, a BMI of 30.7 kg/m², and waist and neck circumferences measuring 104.3 cm and 38.9 cm, respectively. On ESS, 10.2% of patients had excessive daytime sleepiness. According to Berlin (38.9%), the number of patients at high risk of OSA was found to be lower than that of in STOP (53.7%) and STOP-BANG (68.5%) questionnaires. For patients with a BMI<30 kg/m², insufficient consistency was observed between Berlin with STOP and STOP-BANG (p<0.05), whereas there was a concordance between STOP and STOP-BANG (p=0.453). In those with BMI>30 kg/m², while Berlin and STOP were consistent (p=0.824), no concordance was detected between Berlin and STOP-BANG, as well as between STOP and STOP-BANG (p<0.05). The insulin therapy was the associated factor with a high OSA risk in multivariate logistic regression analysis (p=0.041).
Conclusion: The questionnaires used to predict the risk of OSA in T2D exhibit insufficient compatibility. Insulin therapy contributes to the increased risk of OSA in individuals diagnosed with T2D.

Keywords

Berlin Questionnaire , Epworth Sleepiness Scale , STOP-BANG , Obesity , Type 2 diabetes

Ethical Statement

The study was approved by Gazi University Ethical Board (decision number: 481, date: 05 June 2023).

Obstrüktif Uyku Apne Sendromu İçin Yüksek Riskli Olan Tip 2 Diyabet Hastalarının Belirlenmesi

Abstract

Amaç: Mevcut kılavuzlar, tip 2 diyabet (T2D) hastalarının obstrüktif uyku apnesi (OSA) açısından taranmasını önermektedir. Ancak, OSA risk değerlendirmesi için en uygun yöntem konusunda bir fikir birliği yoktur. Diyabeti olan ve OSA riski yüksek olan kişileri belirlemeyi ve yüksek OSA riski değerlendirmesinde kullanılan anketler arasındaki uyumu araştırmayı amaçladık.
Yöntem: OSA riski değerlendirmesi için STOP, STOP-BANG ve Berlin anketleri ve gündüz uykululuğunu araştırmak için Epworth Uykululuk Ölçeği (ESS) kullanıldı.
Sonuçlar: Çalışmaya dahil edilen 108 hastanın ortanca HbA1c değeri %7.5, vücut kitle indeksi (VKİ) değeri 30.7 kg/m² ve bel ve boyun çevreleri sırasıyla 104.3 cm ve 38.9 cm olarak bulundu. ESS’ye göre hastaların %10.2’sinde aşırı gündüz uykululuğu vardı. Berlin anketine göre (%38.9), yüksek OSA riski taşıyan hasta sayısı, STOP (%53.7) ve STOP-BANG (%68.5) anketlerine göre daha düşük bulundu. VKİ<30 kg/m² olan hastalarda, Berlin ile STOP ve STOP-BANG arasında yetersiz tutarlılık gözlenirken (p<0.05), STOP ile STOP-BANG arasında yeterli uyum vardı (p=0.453). VKİ>30 kg/m² olan hastalarda ise Berlin ile STOP arasında tutarlılık gözlenirken (p=0.824), Berlin ile STOP-BANG ve STOP ile STOP-BANG arasında uyum tespit edilmedi (p<0.05). Çok değişkenli lojistik regresyon analizinde, insülin tedavisinin yüksek OSA riski ile ilişkili faktör olduğu bulundu (p=0.041).
Sonuç: T2D'de OSA riskini tahmin etmek için kullanılan anketler yetersiz uyum sergilemektedir. İnsülin tedavisi, T2D tanısı alan bireylerde artmış OSA riski ile ilişkilidir.

Keywords

Berlin anketi , Epworth uykululuk ölçeği , STOP-BANG , Obezite , Tip 2 diyabet

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