Usefulness of the Chin Press Maneuver in Assessing the Severity of Obstructive Sleep Apnea Syndrome

Kim, M J

Abstract

OBJECTIVES
Obstructive sleep apnea syndrome (OSA) is a moderately prevalent disorder. Even through much progress has been made in the diagnosis of this disorder, the cost-effectiveness of nocturnal polysomnography is undertermined and physicians and patients are still hesitant to undergo this procedure. The authors wanted to see the validity of chin press/tongue curl maneuver in estimating the severity of OSA which is easy to measure and was originally proposed by Simmons etc. by looking at the correlations between this score and the conventional respiratory disturbance indices.
METHODS
Forty-three sleep-related breathing disorder patients (28 PSA patients and 15 upper airway resistance syndrome (UARS) patients) who underwent investigation for possible OSA were studied. Two conventional indices of OSA (apnea/hypopnea index (AHI) and oxygen saturation dip rate (SaO2 dips)), four other sleep variables (lowest SaO2, % of time with SaO2, % of with the SaO2<90% (%SaO2<90), % of sleep stage 1, mean length of SaO2 dips) and the score of Epworth sleepiness scale (ESS) were compared with the chin press score (CPS) which was newly revised by the author and ranges from 0 to 6.
RESULTS
The age of subjects was 45.95+/-12.47 (range 14-76) and their average BMI was 25.98+/-3.61 (range 19.65-37.64). There were no significant differences in age, sex and BMI except respiratory disturbance indices and ESS (p<0.05) between OSA and UARS group. Grouped median CPS of the all subjects was 4.14 (range 1-6). There was a remarkable relationship between CPS and diagnosis category (Likelihood Ratio X2 test ; X2=17.41, df=5, p=0.004) and measures of association (Somers'd=0.65+/-0.12, t=4.83, p=0.000) indicated that CPS increased when the diagnosis changed from UARS to OSA. Spearman's rank correlations between CPS and SaO2 dips (R=0.83), between CPS and AHI (R=0.77) were good (p<0.001). Other variables except mean length of SaO2 dips showed good correlations with CPS as well (p<0.05). Regression analysis indicated that when CPS is 3 there is a provability of 0.35 to have AHI of less than 5.
CONCLUSION
Chin press scores that can be measured easily is well correlation with the conventional sleep apnea indices. They may therefore provide a useful guide in diagnosing obstructive sleep apnea syndrome.