Authors: Amira Ishag-Osman, Brandon Barsky, Andrew Dakkak, Serena Spaleny, Nadir Osman, Edith Mensah-Osman.
Study Objective: Obstructive sleep apnea (OSA) is a cause of multiple significant comorbidities and affects hundreds of millions of patients. The prevalence of OSA for adults between the ages of 30 and 70 years old is estimated to be 26%, while the prevalence for the general adult population of more than 18yrs is as high as 38%. Even though OSA affects such a large proportion of the population, the majority of cases are undiagnosed, and approximately 90% of US adults are untreated. These health factors and the economic impact highlight the substantial importance of having accessible and accurate screening tools for OSA.
Subjects and Methods: This is a retrospective analysis of adult volunteer subjects who were recruited for this study. Overall well-being was assessed via questionnaire survey, and physical attributes were extracted from EHR. Daytime saliva and serum were collected from participants ranging between 11am-4pm. PSG was used for the diagnosis of OSA according to AASM guidelines.
Results: BMI did not correlate with a high blood pressure (BP) in the newly diagnosed OSA patient pool, as well as in the general pool of patients. BMI correlated better with neck circumference in the OSA patients. A high BMI was associated with a high AHI value in the newly diagnosed OSA patients. Systolic and diastolic BP correlated with levels of AHI but not for neck circumference in the OSA patients. ESS was not a good predictor of OSA in patients. Levels of DHEA, afternoon cortisol and 17-OH progesterone in saliva of OSA patients were significantly lower when compared to the normal reference range for each marker.
Conclusion: A composite value of large BMI and neck circumference in addition to a high systolic blood pressure may be good indicators of AHI values to assess for OSA risk. Serum glucose was not a good predictor of OSA. However, abnormal levels of products from the adrenal cortex in OSA patients may indicate dys-regulation of the gluconeogenic pathway that may serve as early biomarkers easily accessible from the saliva.
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