Characteristics and Clinical Presentations of Patients at the Siriraj Snoring Clinic

Abstract

Objective: To describe characteristics and clinical presentations of patients in Siriraj snoring clinic and to analyze their relationships with obstructive sleep apnea (OSA) severity.Methods: Three hundred and seventy-three patients’self-administered questionnaires regarding sleep problems recorded between January 2012 and December 2013 and 275 polysomnographic reports were reviewed.Results: Among 373 respondents, there were 247 males (66.2%) and 126 females (33.8%), with an average age of 48 years and body mass index of 28.2 kg/m2.  Their most common complaints and comorbidities were snoring ≥3 nights/week (87.9%), worrying about complications from apnea (72.4%), dyslipidemia (36.7%), hypertension (34.3%), and diabetes mellitus (12.1%), respectively. Using apnea-hypopnea index (AHI) of ≥5 and ≥30 events/hour, there were 76.7% and 38.5% of patients diagnosed as OSA and severe OSA, respectively. While using respiratory disturbance index (RDI) with similar cut-off, almost everyone (98.8%) and 60.2% of patients will be diagnosed as OSA and severe OSA, respectively.  Characteristics significantly associated with AHI ≥15 events/hour were snoring ≥3 nights/week, witnessed apneas, and nocturia (p < 0.05). The comorbidities which significantly associated with OSA group were hypertension, diabetes, and dyslipidemia.  There were only weak significant relationships between AHI (and RDI) with ESS and quality of life.Conclusion: The most common complaints in our clinic were loud snoring and worrying about OSA consequences, not excessive daytime sleepiness. Based on RDI criteria, almost everyone were diagnosed as OSA; however, it had poor relationship with patients’symptoms, comorbidities and quality of life.  Thus, for better OSA evaluation, we should use data from several aspects, not only AHI nor RDI for proper patient management.