THE PROBLEM OF DETECTING OBSTRUCTIVE SLEEP APNEA SYNDROME IN CLINICAL PRACTICE: CLINICAL, DIAGNOSTIC, AND MEDICAL-ORGANIZATIONAL ANALYSIS

Relevance. Obstructive Sleep Apnea is one of the most common sleep-related breathing disorders and is considered an important risk factor for cardiovascular and metabolic diseases.

Objective. To assess the detection rate of obstructive sleep apnea syndrome based on the analysis of clinical data of hospitalized patients, polysomnographic findings, and a survey of primary health care physicians.

Materials and methods. A retrospective descriptive analysis of official statistical data on the registration of obstructive sleep apnea syndrome in the Osh region of the Kyrgyz Republic and Osh city was conducted, along with a review of medical records of 152 patients diagnosed with obstructive sleep apnea syndrome who were hospitalized in the pulmonology department of the Osh Interregional Clinical Hospital during 2020–2024. Polysomnography results from 71 patients, obtained in private medical centers, were analyzed. Additionally, a survey of 78 primary care physicians was conducted to assess awareness and diagnostic practices regarding obstructive sleep apnea syndrome.

Results. The analysis showed that the official registration of obstructive sleep apnea syndrome in the region remains low, indicating underdiagnosis. The study population was predominantly older adults (63.2 ± 12.7 years) with elevated body mass index (median 35 [32–38] kg/m²). A high prevalence of comorbidities was observed, including Chronic Obstructive Pulmonary Disease (90.8 %), Obesity (90.1 %), Hypertension (75.0 %), and Coronary Heart Disease (69.1 %). According to polysomnography, the median apnea-hypopnea index was 18 (10-35.5) events/hour, and the median desaturation index was 32.0 (14.3–46.6) events/hour; most patients had moderate to severe disease. Survey results showed that 63 % of physicians do not use Epworth and STOP-BANG screening questionnaires, and 82 % do not refer patients for polysomnography.

Conclusions. The low detection rate of obstructive sleep apnea syndrome in the region is associated with clinical characteristics of the disease and insufficient use of screening tools and specialized diagnostic methods.

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