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Volume 34, Issue 3 (May & June 2026)
J Adv Med Biomed Res 2026, 34(3): 213-219 |
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Ethics code: IR.TUMS.IKHC.REC.1399.145
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Jalili N, Abtahi H, Rahimi B. Phenotype evaluation in patients with obstructive sleep apnea (AHI>15). J Adv Med Biomed Res 2026; 34 (3) :213-219
URL: http://journal.zums.ac.ir/article-1-7961-en.html
URL: http://journal.zums.ac.ir/article-1-7961-en.html
1- Department of internal medicine, Zanjan university of medical science. Zanjan, Iran , dr.nooshinjalili@zums.ac.ir
2- Advanced thoracic research, Tehran University of Medical Sciences
3- Advanced thoracic research, Tehran University of Medical Sciences, Tehran. Iran
2- Advanced thoracic research, Tehran University of Medical Sciences
3- Advanced thoracic research, Tehran University of Medical Sciences, Tehran. Iran
Abstract: (367 Views)
Background & Objective: Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder characterized by recurrent upper airway obstruction during sleep, leading to arousal and reduced arterial oxygen saturation. This study compared patients with an apnea index <5 and >5 among individuals with moderate-to-severe OSA (AHI >15).
Materials & Methods: This cross-sectional study was conducted at Imam Khomeini Hospital Sleep Laboratory in Tehran, Iran, between 2023 and 2024. Demographic and clinical characteristics of all the patients were recorded. Sleep-related variables included excessive daytime sleepiness assessed using the Epworth Sleepiness Scale, snoring, oxygen desaturation index (ODI), apnea index, apnea hypopnea index (AHI), and the duration of nocturnal oxygen saturation below 90%. Prescribed treatments, including medication, surgery, continuous positive airway pressure (CPAP), or bilevel positive airway pressure (BiPAP), treatment adherence, and the duration of device use were also assessed. Data were analyzed using SPSS version 22.
Results: Among 112 patients, 52.7% were female and 47.3% were male, with a mean age of 51±13.4 years. Overall, 32.1% had hypertension. The mean BMI was 31.84±7.55, mean neck circumference was 40.83 cm, mean ODI was 36.1, mean Epworth Sleepiness Scale score was 11.98±5, and mean AHI was 43.14±31.96. BMI and neck circumference were lower in women, whereas ODI was higher in women. Among 28 patients who received a device, 15 had an apnea index <5 and 13 had an index >5. All patients in the <5 group used the device for >4 hours, compared with 12 patients in the >5 group.
Conclusion: Our findings indicate that addressing barriers to obtaining and using treatment devices may improve treatment adherence. Although a considerable number of patients did not obtain the prescribed device, adherence among those who did was generally favorable, with most patients using the device for at least 4 hours per night.
Materials & Methods: This cross-sectional study was conducted at Imam Khomeini Hospital Sleep Laboratory in Tehran, Iran, between 2023 and 2024. Demographic and clinical characteristics of all the patients were recorded. Sleep-related variables included excessive daytime sleepiness assessed using the Epworth Sleepiness Scale, snoring, oxygen desaturation index (ODI), apnea index, apnea hypopnea index (AHI), and the duration of nocturnal oxygen saturation below 90%. Prescribed treatments, including medication, surgery, continuous positive airway pressure (CPAP), or bilevel positive airway pressure (BiPAP), treatment adherence, and the duration of device use were also assessed. Data were analyzed using SPSS version 22.
Results: Among 112 patients, 52.7% were female and 47.3% were male, with a mean age of 51±13.4 years. Overall, 32.1% had hypertension. The mean BMI was 31.84±7.55, mean neck circumference was 40.83 cm, mean ODI was 36.1, mean Epworth Sleepiness Scale score was 11.98±5, and mean AHI was 43.14±31.96. BMI and neck circumference were lower in women, whereas ODI was higher in women. Among 28 patients who received a device, 15 had an apnea index <5 and 13 had an index >5. All patients in the <5 group used the device for >4 hours, compared with 12 patients in the >5 group.
Conclusion: Our findings indicate that addressing barriers to obtaining and using treatment devices may improve treatment adherence. Although a considerable number of patients did not obtain the prescribed device, adherence among those who did was generally favorable, with most patients using the device for at least 4 hours per night.
Type of Study: Original Research Article |
Subject:
Clinical Medicine
Received: 2026/02/13 | Accepted: 2026/06/2 | Published: 2026/06/29
Received: 2026/02/13 | Accepted: 2026/06/2 | Published: 2026/06/29
References
1. Beaudin A, Waltz X, Hanly PJ, Poulin MJ. Impact of obstructive sleep apnoea and intermittent hypoxia on cardiovascular and cerebrovascular regulation. Exp. Physiol, 2017; 102: 743-63. [DOI:10.1113/EP086051] [PMID]
2. Choi J, Song JS, Lee YJ, Jeong DU. Periodic limb movements in sleep is associated with increased mortality. Psychiatr Investig. 2017; 14, 669-673. [DOI:10.4306/pi.2017.14.5.669] [PMID] [PMCID]
3. Edwards BA, Wellman A, Sands SA, Owens RL, Eckert DJ, White DP, et al. Personalized treatment approaches for obstructive sleep apnea. Am J Respir Crit Care Med. 2023;208(8):889 901.
4. Hnin Kh,Mukherjee S,Antic N,Catcheside P,Coetzer Ch,McEvoy D,et al. The impact of ethnicity on the prevalence and severity of obstructive sleep apnea. Sleep Med Rev. 2018; 4(1): 78-86. [DOI:10.1016/j.smrv.2018.01.003] [PMID]
5. da Silva P, Zhang L. Continuous positive airway pressure for adults with obstructive sleep apnea and cardiovascular disease: A meta-analysis of randomized trials. Sleep Med. 2019; 5(4): 28-34. [DOI:10.1016/j.sleep.2018.09.030] [PMID]
6. Malhotra A, Ayappa I, Ayas N, Collop N, Kirsch D, Mehra R. Advances in the diagnosis of obstructive sleep apnea. Lancet Respir Med. 2023;11(6):543 56.
7. Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, et al. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea. J Clin Sleep Med. 2024;20(2):259 271.
8. Bajwah S, Ross JR, Wells AU, et al. Palliative care for patients with advanced fibrotic lung disease: a randomised controlled phase II and feasibility trial of a community case conference intervention. Thorax. 2015; 70: 8-30. [DOI:10.1136/thoraxjnl-2014-206583] [PMID]
9. Eckert DJ. Phenotypic approaches to obstructive sleep apnoea - New pathways for targeted therapy. Lancet Respir Med. 2023;11(4):321 34.
10. Ramos A, Figueredo P, Shafazand Sh, Chediak A, Abreu A, Dib S, et al.Obstructive sleep apnea phenotypes and markers of vascular disease: A review. Front Neurol, 2017; 8: 659. [DOI:10.3389/fneur.2017.00659] [PMID] [PMCID]
11. de Ruiter M, Benoist L, de Vries N , de Lange J. Durability of treatment efects of the sleep position trainer versus oral appliance therapy in positional OSA: 12- month follow-up of a randomized controlled trial. Sleep Breath. 2018; 2(4): 441-50. [DOI:10.1007/s11325-017-1568-4] [PMID] [PMCID]
12. Pelosi LB, Silveira ML, Eckeli AL, Chayamiti EM, Almeida LA, Sander HH, et al. The importance of clinical monitoring for compliance with continuous positive airway pressure. Braz J Otorhinolaryngol. 2017; 8(3): 439-44. [DOI:10.1016/j.bjorl.2016.05.013] [PMID] [PMCID]
13. Erna S. Obstructive sleep apnoea in the general population: highly prevalent but minimal symptoms, Eur Respir J. 2016; 4(7): 194-202. [DOI:10.1183/13993003.01148-2015] [PMID]
14. Gabbay I. Age- and gender-related characteristics of obstructive sleep apnea. Sleep Breath. 2012; 1(6): 453-60. [DOI:10.1007/s11325-011-0523-z] [PMID]
15. Ghosh D. Identifying poor compliance with CPAP in obstructive sleep apnoea: A simple prediction equation using data after a two-week trial. Respir Med. 2013;107 (6): 936-42. [DOI:10.1016/j.rmed.2012.10.008] [PMID]
16. Awopeju O, Fawale M, Olowookere S, Salami O, Adewole O , Erhabor G. The risk of obstructive sleep apnea and its association with indices of general and abdominal obesity in a Nigerian family practice clinic: a crosssectional study.Alexandria J Med. 2020; 56(1): 14-20. [DOI:10.1080/20905068.2019.1711304]
17. Lin H. Factors associated with noncompliance to treatment with positive airway pressure. Arch Otolaryngol Head Neck Surg. 2007;13(3): 69-72. [DOI:10.1001/archotol.133.1.69] [PMID]
18. Anttalainen U, Saaresranta T, Aittokallio J,Kalleinen N,Vahlberg T,Virtanen I, et al. Impact of menopause on the manifestation and severity of sleep-disordered breathing. Acta Obstet Gynecol Scand. 2006; 8(5): 1381-88. [DOI:10.1080/00016340600935649] [PMID]
19. Kim J. Compliance with positive airway pressure treatment for obstructive sleep apnea, Clin Experiment Otorhinolaryngol. 2009; 2(2): 90-96. [DOI:10.3342/ceo.2009.2.2.90] [PMID] [PMCID]
20. Hayashi Sh , Tamaoka M , Tateishi T , Murota Y , Handa I, Miyazaki Y.A new feature with the potential to detect the severity of obstructive sleep apnoea via snoring sound analysis.Int J Environ Res Public Health. 2020; 1(7): 29- 51. [DOI:10.3390/ijerph17082951] [PMID] [PMCID]
21. Kribbs NB, Pack AI, Kline LR, Smith PL, Schwartz AR, Schubert NM, et al. Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis. 1993; 147(4): 887-95. [DOI:10.1164/ajrccm/147.4.887] [PMID]
22. McArdle N, Devereux G, Heidarnejad H, Engleman HM, Mackay TW, Douglas NJ. Long-term use of CPAP therapy for sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med. 1999; 15(9): 1108-14. [DOI:10.1164/ajrccm.159.4.9807111] [PMID]
23. Claudio W , Dibur E, Salomone C, Bartolo C. Compliance with continuos positive airway pressure in patients with sleep apnea/hypopnea syndrome.Medicina. 2004;64(5):395-9
24. Ayas N , Patel S, Malhotra A, Schulzer M, Malhotra M, Jung D, et al. Auto-titrating versus standard continuous positive airway pressure for the treatment of obstructive sleep apnea: results of a meta-analysis. Sleep. 2004; 27(2): 249-53. [DOI:10.1093/sleep/27.2.249] [PMID]
25. Hui DS, Choy DK, Li TS, Ko FW, Wong KK, Chan JK, et al. Determinants of continuous positive airway pressure compliance in a group of Chinese patients with obstructive sleep apnea. Chest. 2001; 120(1): 170e6. [DOI:10.1378/chest.120.1.170] [PMID]
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