Evaluating Anatomical and Functional Predictors of Obstructive Sleep Apnea Severity in Patients at Tertiary Care Centers in Pakistan
Keywords:
OSA (Obstructive Sleep Apnea), Anatomical Predictors, Pulmonary Functions Tests, ERVAbstract
Background: Obstructive sleep apnea (OSA) is a common breathing disorder that occurs during sleep. It can lead to serious heart and metabolic problems. The cause of OSA includes a mix of anatomical and functional factors that affect the openness of the upper airway. Knowing these factors is important for a correct diagnosis and tailored treatment plan. Objective: To evaluate the relative contribution of anatomical and functional factors to the severity of obstructive sleep apnea (OSA) in patients undergoing assessment at tertiary care centers in Pakistan. Methodology: This study took place at Multan Medical and Dental College and Sahiwal Medical College. It involved 162 adult patients with suspected OSA. All participants underwent overnight polysomnography, lateral cephalometric radiography, pulmonary function testing, and impulse oscillometry. Doctors measured anatomical parameters such as MP, H, tongue length, and soft palate length. They also assessed functional indices like expiratory reserve volume and R20. Statistical analysis helped identify independent predictors of OSA severity based on AHI. Results: Among the 162 patients, 44.4% had severe obstructive sleep apnea (OSA), while 30.2% had moderate OSA and 14.8% had mild OSA. Increased MP-H distance, tongue length, and soft palate length were significantly linked to a higher apnea-hypopnea index (AHI) with a p-value of less than 0.001. Multiple regression analysis found that body mass index (BMI), MP-H distance, ERV, and R20 were independent predictors, explaining 32% of the variance in AHI. Conclusion: This study highlights the important role of both anatomical and functional factors in determining OSA severity. An inferior hyoid position, an enlarged tongue and soft palate, reduced ERV, and increased proximal airway resistance were key contributors. These factors independently predicted AHI, beyond the effects of obesity alone.References
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