Abstract
Background: Obstructive sleep apnea (OSA) is common, underdiagnosed, and associated with cardiometabolic and neurocognitive morbidity. In settings where definitive sleep testing is limited, structured clinical screening may help prioritize symptomatic patients for further evaluation.
Objective: To describe clinical and behavioral characteristics and examine demographic correlates of elevated OSA screening risk among patients attending an ear, nose, and throat (ENT) outpatient department in Tandur.
Methods: This hospital-based cross-sectional study analysed questionnaire data from 30 participants. A study-specific Simple Risk Index classified scores as low (0–5), moderate (6–9), or high (≥10) screening risk. One value exceeding the permitted score for late-night eating/alcohol was capped at 1 and the total score was recalculated. Age was compared between low-risk and moderate/high-risk participants using the Mann–Whitney U test. Differences across all three risk groups were evaluated using the Kruskal–Wallis test. The association between sex and elevated risk was assessed using Fisher’s exact test, with an odds ratio (OR) and 95% confidence interval (CI).
Results: The mean age was 29.5 ± 11.6 years and the median age was 25.5 years (IQR 22.0–29.8); 21 participants (70.0%) were male. Sixteen participants (53.3%; 95% CI 36.1%–69.8%) were low risk, 7 (23.3%; 95% CI 11.8%–40.9%) moderate risk, and 7 (23.3%; 95% CI 11.8%–40.9%) high risk. Overall, 14 participants (46.7%; 95% CI 30.2%–63.9%) had moderate/high screening risk. Sedentary lifestyle (83.3%), daytime sleepiness (63.3%), BMI ≥30 kg/m² (50.0%), and RBC >5.5 million/µL (50.0%) were the most frequent index components. Participants with moderate/high risk were older than low-risk participants (median 34.5 vs 23.0 years; U=184.5; p=0.0027). Age differed across the three categories (H=9.31; p=0.0095) and correlated positively with risk score (Spearman ρ=0.576; p=0.00086). Male sex was not associated with elevated risk (OR 1.14, 95% CI 0.24–5.46; p=1.000).
Conclusion: Nearly half of this small, symptom-enriched ENT outpatient sample had moderate/high screening risk according to the study-specific index, and older age was associated with higher risk. The index is not diagnostic and requires validation against polysomnography or technically adequate home sleep apnea testing.
Keywords: obstructive sleep apnea; screening; otorhinolaryngology; body mass index; daytime sleepiness; cross-sectional study; India.