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Neck Grasp Predicts Obstructive Sleep Apnea in Type 2 Diabetes Mellitus.

P J Edmonds1, K Gunasekaran2, L C Edmonds3

  • 1Vanderbilt University Medical Center, Department of Medicine, 1161 21st Avenue South, Nashville, TN 37232, USA.

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Screening for obstructive sleep apnea (OSA) in type 2 diabetes patients is crucial. The Easy Sleep Apnea Predictor (ESAP) and neck circumference effectively identify individuals at risk for OSA.

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Area of Science:

  • Endocrinology
  • Pulmonology
  • Sleep Medicine

Background:

  • Obstructive sleep apnea (OSA) is a prevalent condition with significant health risks, particularly in patients with type 2 diabetes mellitus (DM).
  • Existing screening tools like the STOP-BANG and Berlin questionnaires can be time-consuming and rely on subjective patient input.
  • There is a need for more objective and efficient methods to screen for OSA in this high-risk population.

Purpose of the Study:

  • To prospectively evaluate the efficacy of neck grasp (via Easy Sleep Apnea Predictor - ESAP) and neck circumference in identifying OSA among patients with type 2 DM.
  • To compare these novel screening methods against established questionnaires and polysomnography (PSG).

Main Methods:

  • Recruited individuals diagnosed with type 2 DM from a primary care setting.
  • Administered screening questionnaires including ESAP, STOP-BANG, and Berlin Questionnaire.
  • Defined a positive ESAP as a 1cm gap when encircling the neck with hands.
  • All participants underwent in-laboratory polysomnography (PSG) for definitive OSA diagnosis.

Main Results:

  • A high prevalence of OSA (90.7%) was observed in the study population (Apnea-Hypopnea Index [AHI] ≥ 5), with a median BMI of 38.0.
  • Prevalence breakdown: mild OSA (27.9%), moderate OSA (25.6%), and severe OSA (37.2%).
  • Both ESAP and neck circumference demonstrated 100% specificity in identifying mild OSA.

Conclusions:

  • This study underscores the importance of screening for OSA in patients with type 2 DM.
  • ESAP and neck circumference are valuable tools for identifying individuals with type 2 DM who are at high risk for OSA.
  • Improved OSA recognition in this population can lead to better management of cardiovascular disease risk.