Risk assessment of obstructive sleep apnea and its association with fatigue and sleepiness among hospital inpatients

Background: Obstructive sleep apnea (OSA) is a common sleep related disorder. Objectives: To identify OSA, its risk factors and to study its association with fatigue and day time sleepiness. Methods: In-patients were interviewed using the STOP-BANG questionnaire, the Fatigue Severity Scale questionnaire and the Epworth Sleepiness Scale. Height, weight and neck circumference of the participants were measured using standard procedures. Results: Of the total 296 participants, 10(3.4%) were known cases of OSA. Of the remaining 286 cases, 189(66.1%) were at low, 82(28.7%) were at intermediate and 15(5.2%) were at high risk of OSA. Age >50 years (P<0.001), male gender (P<0.001) and family history of snoring (P=0.004) among patients were associated with high risk/known status of OSA. Multiple morbidities were seen among greater proportion of participants with higher risk/known status of OSA (P=0.024). Increased body mass index (P=0.013) was associated with higher risk/known status of OSA. High risk/known status of OSA was associated with significant levels of fatigue (P=0.001) and abnormal day time sleepiness (P=0.006) among participants. Multivariate analysis of variables showed age, snoring, witnessed stoppage of breathing, nasal congestion and hypertension as independent risk factors for high risk/known status of OSA. Conclusion: Several factors were identified to predict high risk/known status of OSA among inpatients in this study. High risk/known cases of OSA were found to suffer from multiple comorbidities, significant levels of fatigue and abnormal day time sleepiness. Therefore, inpatients with these associated risk factors need to be screened for OSA so as to ensure comprehensive case management.