Most patients act under crisis of medical emergency. Since SNORING/OSA is not a medical emergency situation; patients are likely to ignore advice given by Physicians or postpone the decision of sleep study to be conducted in Hospital PSG lab for variety of reasons. Sleep studies in Hospitals cost Rs.20, 000/ which may not be covered under medical insurance. Sleep study in Hospital mean spending one night and probably one full day, taking leave. Long waiting list for getting sleep study done in hospitals. Hospital admission frightens patients and his immediate relatives. Concern about confidentiality Under these conditions, Home sleep study is a far simpler, friendlier and cheaper option. Home sleep study is a Type- 3 level study accepted by American Academy of Sleep Medicine which will conclusively prove whether the patient has OSA or not. It will be rather economical for an Indian patient who is not covered under medical claims. It can be done within a day or two- faster, simpler, cheaper and friendlier It is done in the comfort of patients' home, right in his bed without disturbing his schedule. If results are positive, the Sleep Medicine Doctor could be consulted for further action.
There are hardly any scientific surveys done to estimate the prevalence of OSA in India. Taking broad indications from incidence of OSA in USA , we could arrive at an estimate of 6-8% of Indian population could be having OSA.
- 70% of obese have OSA
- 65% of Diabetics have OSA
- 50% of Hypertensive have OSA
- 58% of Diabetics have some form of sleep-disordered breathing
Considering such high incidence, finding out the possibility of OSA should form part of routine diagnosis and treatment of Diabetics. Conducting STOP BANG test should be part of routine examination.
OSA AND KEY FACTS
[Source-International Diabetes Foundation]
- 40% people with OSA will have Diabetes
- In people who have diabetes, the prevalence of some form of sleep disordered breathing may be as high as 58%.
- OSA may have an effect on glycemic control in people with type-2 diabetes.
- OSA is associated with range of cardiovascular complications such as hypertension, stroke and heart failure.
SLEEP APNEA AND TYPE -2 DIABETES
[International Diabetic Federation]
“Diabetes and obstructive sleep apnea [OSA] are common disorders that often co-exist.——Because both Diabetes and OSA are associated with increased cardiovascular morbidity and mortality .Clinicians need to be vigilant in screening diabetic patients for OSA”
SLEEP APNEA TIED TO DIABETES IN LARGE STUDY
[Science Daily June 2014]
“In the largest study to date of the relationship between sleep Apnea and diabetes [8500 patients] has demonstrated a link between Obstructive Sleep Apnea and development of Diabetes. We are able to demonstrate a significant association between OSA severity and the risk of developing Diabetes”
OSA AND GLYCEMIC CONTROL
[PUBMED-Diabetes techno Ther, June 2011]
“Increased severity of OSA is independently associated with worsening glycemic control following adjustments of various co-founders , including insulin dosage ——–Identification and treating patients with T 2D may confer benefits in improving glycemic control”