The Successfulness of A Multidisciplinary Approach For Obstructive Sleep Apnea

Noor Alia Susianti(1*), Caroline Evanthe Nathania(2), Astuti Prodjohardjono(3), Amelia Nur Vidyanti(4), Abdul Gofir(5), Indarwati Setyaningsih(6), Cempaka Thursina Srie Setyaningrum(7), Sri Sutarni(8)
(1) Universitas Gadjah Mada
(2) Universitas Gadjah Mada
(3) Universitas Gadjah Mada
(4) Universitas Gadjah Mada
(5) Universitas Gadjah Mada
(6) Universitas Gadjah Mada
(7) Universitas Gadjah Mada
(8) Universitas Gadjah Mada
(*) Corresponding Author
Abstract
Background: Obstructive Sleep Apnea (OSA) is a global problem that has an impact on health and quality of life (QOL). There are a lot of risk factors for OSA, i.e. anatomical abnormality and comorbidity. A multidisciplinary approach can improve the symptoms and the impact of OSA and QOL too.
Materials and methods: This case report is structured according to The CARE (Case Report) guideline.
Case: A male, 37 years old, came with the chief complaint of snoring for 6 years. The patient felt unfit and dissatisfied with his sleep (Sleep Condition Indicator: 2.5). This impacted the daily activities and caused excessive daytime sleepiness. He could fall asleep while doing activities (Epsworth Sleepiness Scale: 24). The condition was worsening and he was often found apnea during sleep. The patient’s body mass index was 38.3kg/m2 (type I obesity) and the neck diameter was 43 cm. The polysomnography showed sleep architectural abnormality and the patients suffered from moderate OSA (Apnea-Hipopnea Index: 23.7). The patient was hospitalized for 7 days and got a Continuous Positive Airway Pressure Device (CPAP). Anatomical abnormality was investigated but none needed surgical intervention. Metabolic syndrome intervention includes therapy for hypertension, dyslipidemia, and diabetes. Collaboration with a clinical nutritionist for nutritional intervention. After 7 days, the sleep quality, the symptoms, and the SCI score were improved (7.1).
Conclusion: OSA risk factors are varied and needed to be identified. In addition to definitive therapy, management of comorbidities, such as metabolic syndrome, should be addressed. A multidisciplinary approach can thereby improve OSA, patient’s health, and QOL.
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1. Patil SP, Ayappa IA, Caples SM, John Kimoff R, Patel SR, Harrod CG. Treatment of adult obstructive sleep apnea with positive airway pressure: An American academy of sleep medicine systematic review, meta-analysis, and GRADE assessment. Vol. 15, Journal of Clinical Sleep Medicine. American Academy of Sleep Medicine; 2019. p. 301–34. https://doi.org/10.5664/jcsm.7638 PMID: 30736888
2. Lyons MM, Bhatt NY, Pack AI, Magalang UJ. Global burden of sleep-disordered breathing and its implications. Vol. 25, Respirology. Blackwell Publishing; 2020. p. 690–702. https://doi.org/10.1111/resp.13838 PMID: 32436658
3. Léger D, Stepnowsky C. The economic and societal burden of excessive daytime sleepiness in patients with obstructive sleep apnea. Vol. 51, Sleep Medicine Reviews. W.B. Saunders Ltd; 2020. https://doi.org/10.1016/j.smrv.2020.101275 PMID: 32169792
4. Zasadzińska-Stempniak K, Zajączkiewicz H, Kukwa A. Prevalence of Obstructive Sleep Apnea in the Young Adult Population: A Systematic Review. J Clin Med. 2024 Mar 1;13(5). https://doi.org/ 10.3390/jcm13051386
5. Chiu HY, Chou KT, Su KC, Lin FC, Liu YY, Shiao TH, et al. Obstructive Sleep Apnea in Young Asian Adults with Sleep-Related Complaints. Sci Rep. 2022 Dec 1;12(1). https://doi.org/10.1038/s41598-022-25183-5 PMID: 36447027
6. Aini N, Nguyen T V, Khairi S. Understanding Obstructive Sleep Apnoea. The Journal of Palembang Nursing Studies.2024; 3(1): 1–4. https://doi.org/ 10.55048/jpns104PMID: 12808745
7. Subramanian A, Adderley NJ, Tracy A, Taverner T, Hanif W, Toulis KA, et al. Risk of incident obstructive sleep apnea among patients with type 2 diabetes. Diabetes Care. 2019 May 1;42(5):954–63. https://doi.org/10.2337/dc18-2004 PMID: 30862657
8. Xia Y, Fu Y, Wang Y, Qian Y, Li X, Xu H, et al. Prevalence and Predictors of Atherogenic Serum Lipoprotein Dyslipidemia in Women with Obstructive Sleep Apnea. Sci Rep. 2017 Jan 30;7. https://doi.org/10.1038/srep41687 PMID: 28134311
9. Gaines J, Vgontzas AN, Fernandez-Mendoza J, Bixler EO. Obstructive sleep apnea and the metabolic syndrome: The road to clinically-meaningful phenotyping, improved prognosis, and personalized treatment. Vol. 42, Sleep Medicine Reviews. W.B. Saunders Ltd; 2018. p. 211–9. https://doi.org/10.1016/j.smrv.2018.08. 009 PMID: 30279095
10. Hein M, Lanquart JP, Loas G, Hubain P, Linkowski P. Prevalence and risk factors of moderate to severe obstructive sleep apnea syndrome in major depression: A observational and retrospective study on 703 subjects. BMC Pulm Med. 2017 Dec 4;17(1). https://doi.org/10.1186/s12890-017-0522-3 PMID: 29202829
11. Jehan S, Auguste E, Pandi-Perumal SR, Kalinowski J, Myers AK, Zizi F, et al. Depression, Obstructive Sleep Apnea and Psychosocial Health. New York ; 2017 Mar
12. Sahni AS, Carlucci M, Malik M, Prasad B. Management of excessive sleepiness in patients with narcolepsy and OSA: Current challenges and future prospects. Vol. 11, Nature and Science of Sleep. Dove Medical Press Ltd; 2019. p. 241–52. https://doi.org/10.2147/NSS.S218402
13. Yeghiazarians Y, Jneid H, Tietjens JR, Redline S, Brown DL, El-Sherif N, et al. Obstructive Sleep Apnea and Cardiovascular Disease: A Scientific Statement from the American Heart Association. Vol. 144, Circulation. Lippincott Williams and Wilkins; 2021. p. E56–67. https://doi.org/10.1161/CIR.0000 000000000988 PMID: 34148375
14. Pavwoski P, Shelgikar AV. Neurology ® Clinical Practice Treatment options for obstructive sleep apnea. 2017
15. Hynes D, Mansfield D. Diagnosis and Management of Obstructive Sleep Apnoea in Adults. Aust Prescr. 2024 Apr 1;47(2):52–6. https://doi.org/10.18773/ austprescr.2024.010
16. Ahmad M, Makati D, Akbar S. Review of and Updates on Hypertension in Obstructive Sleep Apnea. Vol. 2017, International Journal of Hypertension. Hindawi Limited; 2017. https://doi.org/ 10.1155/2017/1848375
17. Jehan S, Zizi F, Pandi-Perumal SR, Wall S, Auguste E, Myers AK, et al. Obstructive Sleep Apnea and Obesity: Implications for Public Health HHS Public Access. Vol. 1, Sleep Med Disord. 2017
18. Arachchige MA, Steier J. Beyond Usual Care: A Multidisciplinary Approach Towards the Treatment of Obstructive Sleep Apnoea. Front Cardiovasc Med. 2021;8. https://doi.org/10.3389/fcvm.2021. 747495
19. HF P, TLI S, APSM M, MAM C, MO C, GCS B, et al. Multidisciplinary Approach to the Patient with Obstructive Sleep Apnea. J Otol Rhinol. 2017;06(04). https://doi.org/ 10.4172/2324-8785.1000321
20. Elbassiouny AMME. Multidisciplinary Management Algorithm for Snoring and Obstructive Sleep Apnea in Adults with Possible Treatment Models OPEN ACCESS Citation. Annals of Clinical Otolaryngology. 2022;7(1):1056
21. Guidelines to Writing a Clinical Case Report. Heart Views. 2017;18(3):104. https://doi.org/10.4103/1995-705X.217857
22. Rison RA. How to Write a Neurology Case Report. Vol. 10, Journal of Medical Case Reports. BioMed Central; 2016. https://doi.org/10.1186/s13256-016-0867-x PMID: 27048575
23. Riley D. CARE: Case Report Guidelines. IMI LLC. 2017
24. Sapinã-Beltran E, Torres G, Benitez I, Fortuna-Gutierrez AM, Marquez PP, Masa JF, et al. Prevalence, characteristics, and association of obstructive sleep apnea with blood pressure control in patients with resistant hypertension. Ann Am Thorac Soc. 2019;16(11):1414–21. https://doi.org/10.1513/AnnalsATS.201901-053OC PMID: 31514508
25. Castaneda A, Jauregui-Maldonado E, Ratnani I, Varon J, Surani S. Correlation between metabolic syndrome and sleep apnea. World J Diabetes. 2018 Apr 15;9(4):66–71. https://doi.org/10.4239/wjd. v9.i4.66
26. Framnes SN, Arble DM. The bidirectional relationship between obstructive sleep apnea and metabolic disease. Vol. 9, Frontiers in Endocrinology. Frontiers Media S.A.; 2018. https://doi.org/10.3389/ fendo.2018.00440
27. Ellender CM, Vakulin A, Stocks Chang LCC. Management of Obstructive Sleep Apnoea in Primary Care. Aust J Gen Pract [Internet]. 2024 Jun [cited 2024 Nov 27];53(6)
28. Finke H, Drews A, Engel C, Koos B. Craniofacial risk factors for obstructive sleep apnea—systematic review and meta-analysis. J Sleep Res. 2024 Feb 1;33(1). https://doi.org/10.1111/jsr.14004 PMID: 37485571
29. Javaheri S, Javaheri S, Somers VK, Gozal D, Mokhlesi B, Mehra R, et al. Interactions of Obstructive Sleep Apnea With the Pathophysiology of Cardiovascular Disease, Part 1. J Am Coll Cardiol. 2024 Sep;84(13):1208–23. https://doi.org/10.1016/j.jacc.2024.02.059
30. Almendros I, García-Río F. Sleep apnoea, insulin resistance and diabetes: The first step is in the fat. Vol. 49, European Respiratory Journal. European Respiratory Society; 2017. https://doi.org/10.1183/13993003.00179-2017 PMID: 28424366
31. Qiu ZH, Liang SF, Deng X Bin, Wei QS, Luo YM, Wang L, et al. Treatment of Obstructive Sleep Apnea with A Simple CPAP Device. Sleep and Breathing. 2023 Dec 1; 27(6): 2351–9. https://doi.org/ 10.1007/s11325-023-02823-2 PMID: 37211583
32. Liu J, Xu J, Guan S, Wang W. Effects of Different Treatments on Metabolic Syndrome in Patients with Obstructive Sleep Apnea: a Meta-Analysis. Vol. 11, Frontiers in Medicine. Frontiers Media SA; 2024. https://doi.org/10.3389/fmed.2024. 1354489

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