Prevalence and predictors of obstructive sleep apnea in snorers without excessive daytime sleepiness

Introduction Obstructive sleep apnea (OSA) can be presented by diverse phenotypes with or without excessive daytime sleepiness (EDS). The present study was conducted to detect the prevalence and the predictors of OSA in a sample of habitual snorers without EDS nor nocturnal observed apnea. Patients and methods A total of 61 adult participants complaining of habitual snoring were included in the study and subjected to OSA screening questionnaire, anthropometric measures, tonsil examination, modified Mallampati score, and full polysomnography. Univariate analysis and regression analysis were done to detect the association of OSA with participants' characteristics and polysomnography data. The statistically significant variables were entered into the receiver operating characteristic curve to estimate the best cutoff values for predictors of OSA in habitual snorers. Results The studied patients were divided into two groups: 11.5% had no OSA [apnea-hypopnea index (AHI)< 5], and 88.5% had OSA. AHI values were significantly greater in males compared with females [45.2 (interquartile range: 29.9-62.6) in males versus 22.1 (interquartile range: 9.6-35.9) in females, P=0.001]. There was a statistically significant positive correlation between AHI and age (r=0.39). The best cutoff point of age to detect OSA group was more than 43 years with a sensitivity of 64.81%, specificity of 100%, and total accuracy of 0.86. The best cutoff point of BMI to detect OSA group was more than 37 kg/m(2), with a sensitivity of 46.30%, specificity of 100%, and total accuracy of 0.75. Conclusion OSA should be investigated in habitual snorers even in the absence of EDS and nocturnal apnea, especially in older (> 43 years), obese (BMI > 37 kg/m2), and male patients.