Snoring during Bronchoscopy with Moderate Sedation Is a Predictor of Obstructive Sleep Apnea

Cho, Jaeyoung; Choi, Sun Mi; Park, Young Sik; Lee, Chang-Hoon; Lee, Sang-Min; Lee, Jinwoo

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저자정보: Cho, Jaeyoung (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital) Choi, Sun Mi (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital) Park, Young Sik (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital) Lee, Chang-Hoon (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital) Lee, Sang-Min (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital) Lee, Jinwoo (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital)

저널정보: 대한결핵 및 호흡기학회 Tuberculosis and Respiratory Diseases 결핵 및 호흡기 질환 제82권 제4호

발행연도: 2019.1

수록면: 335 - 340 (6page)

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Background: Snoring is the cardinal symptom of obstructive sleep apnea (OSA). Snoring and upper airway obstruction associated with major oxygen desaturation may occur in populations undergoing flexible bronchoscopy. Methods: To evaluate the prevalence of patients at a high risk of having OSA among patients undergoing bronchoscopy with sedation and to investigate whether snoring during the procedure predicts patients who are at risk of OSA, we prospectively enrolled 517 consecutive patients who underwent the procedure with moderate sedation. Patients exhibiting audible snoring for any duration during the procedure were considered snorers. The STOP-Bang (Snoring, Tiredness, Observed apnea, high blood Pressure-Body mass index, Age, Neck circumference and Gender) questionnaire was used to identify patients at high (score ${\geq}3$ out of 8) or low risk (score <3) of OSA. Results: Of the 517 patients, 165 (31.9%) snored during bronchoscopy under sedation. The prevalence of a STOP-Bang score ${\geq}3$ was 61.9% (320/517), whereas 200 of the 352 nonsnorers (56.8%) and 120 of the 165 snorers (72.7%) had a STOP-Bang score ${\geq}3$ (p=0.001). In multivariable analysis, snoring during bronchoscopy was significantly associated with a STOP-Bang score ${\geq}3$ after adjustment for the presence of diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, and stroke (adjusted odds ratio, 1.91; 95% confidence interval, 1.26-2.89; p=0.002). Conclusion: Two-thirds of patients undergoing bronchoscopy with moderate sedation were at risk of OSA based on the screening questionnaire. Snoring during bronchoscopy was highly predictive of patients at high risk of OSA.

#Snoring #Bronchoscopy #Conscious Sedation #Sleep Apnea, Obstructive

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