Outcomes of Patients Presenting to Sleep Disorder Clinic in Otolaryngology Practice

Abstract

Objectives:

Continuous positive airway pressure (CPAP) has become the standard of care for obstructive sleep apnea (OSA). However, CPAP compliance has been shown to be poor and surgical correction of upper airway may be an option for selected patients. The study aimed to assess the outcomes of patients presenting to sleep disorder clinic with OSA.

Methods:

Subjects were identified by reviewing sleep laboratory records of patients presented for full polysomnography from 2010 to 2014. Case notes were traced and data collected retrospectively. The treatment prescribed include weight reduction, CPAP, surgery and oral appliance. The outcomes of treatment options offered were analyzed and full polysomnography parameters before and after treatment were compared.

Results:

Less than 20% of patients underwent surgical correction of the upper airway. Less than 50% of the patients used an oral appliance. More than 60% of patients showed improvement in the respiratory disturbance index (RDI) after the surgery. About 80% of patients defaulted treatment subsequently. A small proportion of patients were discharged from the sleep disorder clinic after significant improvement of symptoms.

Conclusions:

Surgery is indicated in patients who have a specific underlying abnormality causing the OSA and if they refused or failed CPAP therapy. However, only a small proportion of patients have such correctible lesions.