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11. Conclusion 10. Adherence to investigation 6. EDS by Epworth SS in OSA pts. (165) 6. EDS by Epworth SS in OSA pts. (165) 2. Suspicion of OSA in 210 pts group (in a public Pulmonology Clinic) 2. Suspicion of OSA in 210 pts group (in a public Pulmonology Clinic) Obstructive Sleep Apnea - Correlations between Clinical Exam, Epworth Sleepiness Scale and Sleep Study Tools (Polygraphy and Polysomnography) G. Jimborean 1, I. Dombi 1, P. Postolache 2, E.S. Ianosi 1 1 University of Medicine and Pharmacy Tîrgu Mures, 2 University of Medicine and Pharmacy Iași/RO 5. Gender distribution Header 1.ICSD, 3rd ed, American Academy of Sleep Medicine, Darien, IL 2014 Clinical suspicion of OSA was based on ICSD3 recommendations and allowed a good patients’ selection for RSD investigation OSA was more frequent in males than females - 5.6 : 1 OSA pts. = Overweight - 21.8%, Obesity I-II - 47%, Morbid O - 26% 82.4% of 210 investigated subjects had S apneea and 78.5% OSA The detailed clinical exam with proper patient’ selection, Epworth scale and PG with at least 4 channels allowed the correct OSA diagnosis, increased compliance and precocity to investigation, was cheap and permited a prompt introduction of the CPAP therapy In 87% of cases with PSG there was about 3 months delay in treatment initialization (delay in appointments, hospitalisation, for Investigation and titration !! waiting list ) Adherence to CPAP is still low (50.3%) despite of the severe OSA and the repeated messages/education on every medical consult (lack of coverage by insurances companies) Financial coverage of CPAP / VNI by Public National Insurances would increase compliance to treatment and would allow a proper early treatment to decrease complications, overmortality and the further high medical costs Any commercial support of the original research presented, any financial interests held by the first, last and corresponding author Aderence to investigation Clinical exam Excessive Daytime Sleepiness EDS - 190 (90.4%) Snoring - 189 (90%) Mood disorders - 201 (95.7%) Sleep AH proved by the partner - 112 (53.3%) Sexual dysfunction - 140/172males (81.4%) HTA under 60 y - 38/100 (38%) HTA in the entire group - 98/210 (46.6%) Poor sleep - 78 (37.1%) Fatigue - 45 (21.4%) 3. Age distribution 4. Nutritional status BMI 210 adults with clinical suspicion for OSA and high Epworth Sleepiness Scale score 155 PG and 55 PSG 173 pts (82.4%) Mod/severe Sleep Apneea 165 pts (95.4%) OSA CPAP Indication 8 CSA CHF, AF – Cardio Exam Stroke, TU ? – CT, Neuro 37 subjects without A/H pattern Sleep diary, Neuropsychiatric exam Other Sleep Disorder? PSG Organic disease? COPD,BRGE, asthma? EKG, heart US, Spirometry 88 85 25 86 43 Adherence to investigation was higher in those with PG (2 exam for diagnosis + 1 for initial treatment setting – APAP titration) unlike those with PSG (60% required 3 consults for diagnostic - for information, PSG acceptance, scheduling and performing and 1-2 nights for treatment. In 87% of PSG cases - 3 mo delay in treatment initialization M/F = 5.6/1 1. Study group and design 140 84.8% 140 84.8% 7. OSA concordance with Epworth SS in patients with PG (125) 7. OSA concordance with Epworth SS in patients with PG (125) 118 94% 118 94% 9. Treatment 40/55 (72.7%) 40/55 (72.7%) 125/ 155 (80.6%) 125/ 155 (80.6%) 8. Correlation between the type of sleep investigation (PG or PSG) and no. of pts. with OSA (Only)
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