Dados do Trabalho

Título

Epidemiological and Clinical Profile of Patients with Obstructive Sleep Apnea and Obesity in a Home Ventilatory Support Program

Introdução

Obstructive Sleep Apnea (OSA) affects approximately 38% of the adult Brazilian population and shares pathophysiological characteristics and risk factors with cardiovascular, metabolic, and cerebrovascular diseases. Obesity stands out as a significant common risk factor among these conditions.

Objetivo

To outline the epidemiological and clinical profile of patients with OSA and obesity treated in a public sleep physiotherapy outpatient clinic under the Unified Health System (SUS).

Métodos

This observational, cross-sectional, and retrospective study analyzed medical records of patients enrolled in a home ventilatory support program under SUS. The selected records included patients of both sexes, aged ≥ 18 years, diagnosed with OSA through polysomnography, and with a BMI > 30 kg/m². Data collected included sociodemographic, anthropometric, and clinical parameters from the initial CPAP adaptation evaluation. The data were analyzed using Microsoft Excel and are presented as means, standard deviations, and percentages.

Resultados

A total of 80 medical records were analyzed. The sample consisted of 51.2% women, with a mean age of 55.90 ± 11.21 years, BMI of 36.38 ± 5.22 kg/m², abdominal circumference of 117.6 cm, and neck circumference of 42.15 cm. The apnea-hypopnea index (AHI) was 42.96 ± 22.63 events/h, and the oxygen desaturation index (ODI) was 38.92 ± 18.93 events/h. The mean time with SpO2 < 90% was 87.85 ± 102.91 minutes. Severe OSA was diagnosed in 68.8% of patients. The most prevalent comorbidities were hypertension (78.8%), diabetes mellitus (38.8%), COPD (11.3%), asthma (7.5%), myocardial infarction (6.3%), heart failure (5%), and arrhythmias (8.8%). The most common complaints were snoring (55%), choking (33.8%), and excessive daytime sleepiness (31.3%). Morning headache was reported by only 10% of the patients. The most commonly used medications were antihypertensives (78.8%) and diuretics (38.8%). All patients used CPAP with a nasal mask (96.3%), with a therapeutic pressure of 8.59 ± 1.177 cmH2O. The mean treatment duration was 1.64 ± 0.94 years, and the adherence rate during the first 30 days of use was 89.4%.

Conclusões

There was a high prevalence of hypertension and diabetes mellitus associated with OSA in this population. Despite being a frequent symptom, most patients did not report morning headaches.Most patients showed good initial adherence to treatment, with a consistent use of the CPAP device for more than one year.

Palavras -chave

Obstructive Sleep Apnea; Obesity; Obesity Hypoventilation Syndrome