# Obstructive Sleep Apnea Screening Among Hypertensive Patients in Low-Resource Settings

## TL;DR

This study explores factors that can help identify hypertensive patients at risk for obstructive sleep apnea in low-resource settings.

## Contribution

The study identifies additional risk factors that improve OSA screening when combined with existing tools in hypertensive patients.

## Key findings

- 25.4% of patients were identified as high risk for sleep disorders using the Berlin Questionnaire.
- Smoking, alcohol consumption, traffic accident history, and sleeping pill use correlated with positive screening results.
- The study suggests these factors can guide referrals to sleep medicine centers in low-resource areas.

## Abstract

Introduction: In low-resource countries, where sleep medicine centers are limited, screening tools are essential for identifying individuals at risk for obstructive sleep apnea (OSA). This study aimed to identify additional factors that, in combination with the Berlin Questionnaire (BQ) and the Epworth Sleepiness Scale (ESS), could improve the identification of hypertensive patients requiring further evaluation.

Subjects and methods: This cross-sectional study was conducted at the Family Medicine Service of the Public Health Institution "Dr. Mladen Stojanovic" in Laktasi, Bosnia and Herzegovina, which serves approximately 35,000 inhabitants. Using a questionnaire with defined important parameters alongside screening tools - BQ and ESS - the study aimed to present descriptive indicators of the observed population and to determine identifiers of sleep disorders (primarily OSA) using the chi-square test.

Results: A total of 500 patients with arterial hypertension (254 females and 246 males; median age 60 years (IQR: 50-68 years) and median body mass index (BMI) 26.9 kg/m² (IQR: 24.8-29.8 kg/m²)) were screened using the BQ and the ESS. High risk for sleep disorders was identified in 25.4% of subjects using the BQ and in 25% using the ESS. Smoking, alcohol consumption, a history of causing a traffic accident, and the use of sleeping pills were correlated with positive results on both screening tests.

Conclusion: Patients with arterial hypertension who smoke, consume alcohol regularly, have a positive history of causing a traffic accident, and use sleep medications may benefit from screening for OSA and consideration for referral to sleep medicine centers.