Severity of obstructive sleep apnea diagnosed incidentally during gastrointestinal endoscopy under conscious sedation

It remains unclear whether patients diagnosed as having obstructive sleep apnea (OSA) incidentally while undergoing gastrointestinal endoscopy under conscious sedation (GE-CS) have predominantly mild disease.

We evaluated differences in the disease characteristics, severity and treatments received between patients who were suspected as having OSA during GE-CS (GE group, n = 56) and patients who visited our hospital with a history of OSA-related symptoms (SY group, n = 123).

The median age of patients, percentage of men and percentage of patients with obesity were 54 years, 68%, and 21% in the GE group and 51 years, 78%, and 31% in the SY group, respectively. The percentages of patients with mild, moderate, and severe OSA were 18%, 36%, and 43% in the GE group and 30%, 17%, and 39% in the SY group, respectively. The percentages of patients with subjective symptoms (e.g., daytime sleepiness/tiredness, 61% vs. 75%, p = 0.056) and scores on the Epworth sleepiness scale of ≥ 11 (18% vs. 37%, p = 0.009) were lower in the GE group, whereas there was no difference in the proportion of patients with objective symptoms (e.g., loud snoring or apnea, 70% vs. 70%) between the two groups. Patients with moderate-to-severe OSA who received continuous positive airway pressure (CPAP) therapy were fewer in the GE group (34% vs. 65%, p = 0.001).

A large percentage of patients with OSA diagnosed incidentally while undergoing GE-CS had moderate-to-severe disease but refused CPAP as they often had few subjective symptoms.