SLEEP RESPIRATORY DISORDERS IN

MEDICAL STUDENTS

Maxwel Pereira da Costa

Maria Noel Marzano Rodrigues Petruzzi

Sérgio Henrique Kiemle Trindade

Bauru School of Dentistry/University of São Paulo

maxwel.costa@usp.br

and NoSAS (4.68%). Those with excessive

Objectives
The present study aimed to investigate the
occurrence of obstructive sleep apnea (OSA)
and related symptoms in young adults through
alternative screening parameters.
Materials and Methods
This prospective and cross-sectional study
included 64 undergraduate medical students.
Sociodemographic (sex and age) and
anthropometric data (NC = neck circumference
and BMI = body mass index) were
systematically collected. The survey was self-
administered, including the Epworth sleepiness
scale (ESS), Berlin questionnaire (BQ), STOP-
Bang and NoSAS. The same day they
underwent portable home sleep monitoring
using the BiologixTM (Oxistar™, Biologix
Sistemas Ltd., Brazil) device. Scoring of the
oxygen desaturation index (ODI) events/hour
were: <5 without OSA, 5 ≤ ODI <15 = mild or
moderate OSA, ODI ≥15 = severe OSA.
Descriptive and inferential statistics were
performed for data analysis (P ≤0,05).
Results
The evaluated sample comprised 38 (59.37%)
males, aged 22.28±2.34 years (table 1). Males
presented higher values of BMI, NC, ODI
events/hour, and continuous values in BQ,
STOP-Bang, and NoSAS than females (P
≤0,05). A high risk for OSA frequency was
detected in BQ (10.93%), STOP-Bang (4.68%),
diurnal sleep and overweight presented an
increased relative risk of having mild/moderate
OSA (P ≤0,05), which was diagnosed in 4.68%
of the sample through a home monitoring sleep
test (Picture 1). There was a moderate and
statistically significant positive correlation
between: ODI vs. BQ (r=0.313) and vs. NoSAS
(r=0.427), ESS vs. BQ (0.400), BQ vs. STOP-
Bang (r=0.386) and vs. NoSAS (0,327), and
STOP-Bang vs. NoSAS (r=0.461) (Pearson
correlation, P≤0.05).
Picture 1: Graphic representation (colorblind safe) of
the association between (A) sleep propensity in daily
situations vs. oxygen desaturation index (ODI)
events/hour; and (B) body mass index (≥ 25kg/m2)
vs. ODI events/hour. The analysis was made using
Fisher's exact test. *P≤0.05.
Conclusions
Despite a low occurrence of OSA among young
adults, males presented a higher prevalence of
OSA's associated factors than females,
indicating that they should be early and
systematically screened for this disorder.
Considering their discriminatory ability,
questionnaires and a home monitoring sleep
tests together, should be considered in low-
income settings as an alternative screening
resource for OSA. Educational strategies to
raise awareness about OSAS should be
encouraged in university settings.
References
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Table 1: Mean and median values [95% CI] of the assessed variables compared by sex, age, and BMI ranges.
Sex Age BMI

Variables Male Female <25 years ≥25 years <25kg/m2 ≥25kg/m2

(N=64) (N=38) (N=26) (N=56) (N=8) (N=46) (N=18)
Age 22.00 20.00 22.00a 27.00a 22.00 22.00
BMI 23,97±3,41 21,46±3,16b 23,09±3,50 22,00±3,66 20,91±1,96c 27,14±1,85c
b

NC 37,00d 31,00d 36,00e 30,50e 34,00f 38,00f

ODM:
RT 378,20±74, 433,70±77,7 396,50±70, 430,40±131, 406,30±73, 388,20±406,30
22g 3g 55 21 41
ODI 2,20h 1,10h 1,50 2,00 1,50i 1,80i
SpO2min 92,00 92,00 92,00 90,25 92,00 92,00
SpO2médio 97,00j 98,00j 96,50 96,00 97,00 96,00

ESS 7,71±4,22k 10,42±4,45k 8,76±4,48 9,12±4,85 8,88±4,67 8,67±4,19

BQ 1,47±1,70 1,73±1,58 1,57±1,65 1,62±1,76 1,37±1,51 2,00±1,87

SB 1,47±0,64l 0,38±0,57l 0,87±0,83 1,03±0,80 0,93±0,79 1,19±0,81

NoSAS 4,21±2,38m 1,19±1,74m 3,00±2,56 2,87±3,04 1,48±1,31n 6,04±1,74n

BMI = body mass index, NC = neck circumference, ODM = overnight digital monitoring, RT = recording time,
ODI = oxygen desaturation index, SPO2 min = minimum oxygen saturation, ESS= Epworth sleepiness scale, BQ
= Berlin questionnaire, SB = STOP-Bang. Letters indicate statistical significant differences (P≤0.05). Mann-
Whitney and t-test were used to compare medians and means, respectively.