Tuberc Respir Dis.  2019 Oct;82(4):335-340. 10.4046/trd.2019.0007.

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

Affiliations
  • 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. realrain7@gmail.com
  • 2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

Abstract

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 ≥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 ≥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 ≥3 (p=0.001). In multivariable analysis, snoring during bronchoscopy was significantly associated with a STOP-Bang score ≥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.

Keyword

Snoring; Bronchoscopy; Conscious Sedation; Sleep Apnea, Obstructive

MeSH Terms

Airway Obstruction
Apnea
Bronchoscopy*
Conscious Sedation*
Diabetes Mellitus
Humans
Mass Screening
Neck
Odds Ratio
Oxygen
Prevalence
Prospective Studies
Pulmonary Disease, Chronic Obstructive
Renal Insufficiency, Chronic
Sleep Apnea, Obstructive*
Snoring*
Stroke
Oxygen

Figure

  • Figure 1 Proportion of snorers and nonsnorers with low, intermediate, and high risk of obstructive STOP-Bang (Snoring, Tiredness, Observed apnea, high blood Pressure-Body mass index, Age, Neck circumference and Gender) questionnaire.


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