[Clinical presentation of obese patients with polysomnographic diagnosis of obstructive sleep apnea]. / Apresentação clínica de pacientes obesos com diagnóstico polissonográfico de apnéia obstrutiva do sono.

AIM: To evaluate the symptoms of obese patients with polysomnographic diagnosis of obstructive sleep apnea (OSA). METHODS: All obese patients (BMI > or =30 kg/m(2)) that accomplished overnight polysomnography in two sleep laboratories in the city of Salvador, BA, Brazil, in the period of July to December of 2004, and had an apnea hypopnea index (AHI) > or =5. The considered symptoms were excessive daytime sleepiness, awakenings during the night and nocturnal choking or gasping. RESULTS: 73 patients were included, being 57.5% male, with mean age and BMI of 45.2 years old and 38.0 kg/m(2), respectively. The majority (49.3%) was classified as having severe OSA (AHI > or =30). Data revealed that 19.2% of the patients did not have any symptoms, while 28.8% had one symptom, 30.1% had two and 21.9% had three. There was no statistically significant difference in the severity of OSA between the subjects with and without symptoms. There was a higher prevalence of asymptomatic patients in the subgroup with severe obesity--BMI > or =35 kg/m(2) (30.8% vs. 5.9%; p = 0.007). CONCLUSIONS: The polysomnography seems to be a fundamental exam in the evaluation of obese patients due to the elevated prevalence of asymptomatic individuals with OSA in this group, especially the severely obese.

Apresentação clínica de pacientes obesos com diagnóstico polissonográfico de apnéia obstrutiva do sono / Clinical presentation of obese patients with polysomnographic diagnosis of obstructive sleep apnea

OBJETIVO: Avaliar a sintomatologia de pacientes obesos com diagnóstico polissonográfico de Síndrome da Apnéia/Hipopnéia Obstrutiva do Sono (SAHOS). MÉTODOS: Foram avaliados todos os pacientes obesos (IMC > 30 kg/m²) que realizaram polissonografia em dois laboratórios de sono da cidade de Salvador, BA, no período de julho a dezembro de 2004 e apresentaram Índice de Apnéia/Hipopnéia (IAH) > 5 ev/h/sono. Os sintomas considerados foram sonolência excessiva diurna, despertares noturnos, sensação de engasgos e/ou sufocamentos durante o sono. RESULTADOS: Foram incluídos 73 pacientes, sendo 57,5 por cento do sexo masculino com média de idade e IMC de, respectivamente, 45,2 anos e 38,0 kg/m². A maioria (49,3 por cento) foi classificada como SAHOS grave (IAH > 30). Os dados revelaram que 19,2 por cento destes pacientes não apresentavam nenhum dos sintomas pesquisados, 28,8 por cento, apenas um sintoma, 30,1 por cento, dois e 21,9 por cento, três. Não houve diferença estatisticamente significante em relação à gravidade da doença entre os indivíduos com e sem sintomas. Houve uma maior freqüência de pacientes assintomáticos entre os pacientes com obesidade severa (30,8 por cento versus 5,9 por cento; p = 0,007). CONCLUSÕES: A polissonografia parece ser um exame fundamental na avaliação de pacientes obesos devido à alta taxa de indivíduos assintomáticos com índices polissonográficos alterados neste grupo, em especial nos obesos graves.

AIM: To evaluate the symptoms of obese patients with polysomnographic diagnosis of obstructive sleep apnea (OSA). METHODS: All obese patients (BMI > 30 kg/m²) that accomplished overnight polysomnography in two sleep laboratories in the city of Salvador, BA, Brazil, in the period of July to December of 2004, and had an apnea hypopnea index (AHI) > 5. The considered symptoms were excessive daytime sleepiness, awakenings during the night and nocturnal choking or gasping. RESULTS: 73 patients were included, being 57.5 percent male, with mean age and BMI of 45.2 years old and 38.0 kg/m², respectively. The majority (49.3 percent) was classified as having severe OSA (AHI > 30). Data revealed that 19.2 percent of the patients did not have any symptoms, while 28.8 percent had one symptom, 30.1 percent had two and 21.9 percent had three. There was no statistically significant difference in the severity of OSA between the subjects with and without symptoms. There was a higher prevalence of asymptomatic patients in the subgroup with severe obesity - BMI > 35kg/m² (30.8 percent vs. 5.9 percent; p = 0.007). CONCLUSIONS: The polysomnography seems to be a fundamental exam in the evaluation of obese patients due to the elevated prevalence of asymptomatic individuals with OSA in this group, especially the severe obese.