Unmasking the cloak of comorbidities in OSA-association and their severity – a prospective observational study [version 1; peer review: 1 approved with reservations]

Background: Obstructive sleep apnoea (OSA) is a common sleep disorder with high prevalence in the community but highly underreported. It is also seen that a significant number of cases with OSA are associated with various comorbidities. The study objective was to estimate and assess the specific type and proportion of various comorbidities seen in association with OSA and association of severity of OSA with comorbidities. Methods: The study was a hospital-based descriptive study of 85 patients with OSA. Descriptive statistics were used to analyse the data and Chi-square test was done to find out the association. Results: The most common comorbidity associated with OSA was obesity (60%). Around half of the patients (49.4%) had severe OSA based on Apnea Hypopnea Index (AHI) scores. Statistically significant association was seen between presence of comorbidities, like diabetes and hypertension, and risk of OSA based on the snoring, tiredness, observed apnea, blood pressure (S.T.O.P) questionnaire. Conclusions: In our study, a significant proportion (73%) of patients with OSA had associated comorbidities at the time of initial diagnosis. This indicates a delayed diagnosis as OSA is diagnosed only after multiple and irreversible comorbidities have developed. A majority (49%) had a severe OSA on initial presentation. This combination of multiple comorbidities and severe OSA at the time on diagnosis is reflective of a huge problem that is peculiar to OSA at large at a community level.