Neck Grasp Predicts Obstructive Sleep Apnea in Type 2 Diabetes Mellitus

Abstract EN

Aims.

Obstructive sleep apnea (OSA) is a common disorder with high morbidity, mortality, and an increasing prevalence in the general population.

It has an even higher prevalence among individuals with type 2 diabetes mellitus (DM).

The snoring, tiredness, observed apnea, high blood pressure, body-mass-index, age, neck circumference and male gender (STOP-BANG) questionnaire and Berlin Questionnaire can be cumbersome in clinical practice and require subjective data on sleepiness.

We proposed prospectively studying a primary care population with type 2 DM comparing neck grasp, neck circumference, and common screening questionnaires to identify OSA.

Methods.

Persons with a diagnosis of type 2 DM were recruited from a primary care clinic.

Participants were screened using Easy Sleep Apnea Predictor (ESAP), STOP-Bang questionnaire, and Berlin questionnaire.

A positive ESAP was defined as a 1cm gap when a patient encircled their hands around the neck.

All subjects underwent in-laboratory PSG testing.

Results.

Forty-three participants were enrolled and the prevalence of OSA was 90.7% (AHI ≥ 5).

The median BMI was 38.0.

The prevalence of mild OSA by PSG (AHI 5-14) was 27.9%, moderate OSA (AHI 15-29) was 25.6%, and severe OSA (AHI >30) was 37.2%.

For mild OSA both ESAP and neck circumference showed 100% specificity.

Conclusions.

This study reinforces the need for screening diabetic persons for obstructive sleep apnea.

ESAP and neck circumference are useful for identifying persons with type 2 DM who are at risk for OSA.

Together these findings could improve recognition of OSA in persons at risk for cardiovascular disease.

Trial Registration of “Neck grasp as a predictor of Sleep Apnea,” https://clinicaltrials.gov/ct2/show/NCT02474823, Clinical Trials.gov Identifier, is NCT02474823.