The relationship between clinical and laboratory findings and duration of sleep where oxygen saturation remains below 90-95% in obstructive sleep apnea
Avci, Aynur Yilmaz
Yagbasan, Berna Devrim
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Objective: The aim of the present study was to determine correlations between CT90 and CT95 values and physical examination parameters, chronic metabolic diseases, smoking, mean platelet volume, cerebral magnetic resonance imaging (MRI), presence and number of hyperintense foci in obstructive sleep apnea (OSA). Methods: A total of 1154 patients who underwent polysomnography in our sleep laboratory between 2011 and 2014 were screened retrospectively. Among them, 72 cases who underwent ear, nose and throat examinations, cerebral MR, CBC and biochemical tests were included in the study. All patients underwent a detailed anamnesis together with (1) measurements of BMI (body mass index) (2) circumferences of neck and abdomen, (3) examination of oropharynx, (4) Muller maneuver with the aid of fiberoptic endoscope, (5) estimation of Epworth sleep scale scores, (6) and polysomnographic (PSG) tests. Results: According to the severity of OSA, the patients had simple snoring (22.2%), mild (19.4%) and severe OSA (38.9%). In multivariate regression analysis, body mass index (BMI) (p=0.026) and apnea/hypopnea index (AHI) (p=0.013) were seen as independent variables affecting CT90 (R-2=49%). Multivariate linear regression analysis demonstrated that independent variables of smoking (p=0.001), AHI (p=0.003) and number of hyperintense foci (p=0.013) affected CT95 (R-2=%47.9), while relationships between diabetes, BMI and CT95 were not statistically significant. Conclusion: Since CT95 values are affected by smoking without any statistically significant correlation with retropalatal and retroglossal Muller stages, we think that consideration of CT90 value will be more appropriate in the evaluation of the severity of chronic intermittent hypoxia in patients with obstructive sleep apnea. However, the correlation between CT90 value and AHI is closer to the value indicated in the literature, but not stronger.