Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Nov 16, 2016; 8(19): 697-700
Published online Nov 16, 2016. doi: 10.4253/wjge.v8.i19.697
Patients presenting for colonoscopy: A great opportunity to screen for sleep apnea
Glenn Harvin, Eslam Ali, Amit Raina, William Leland, Sabeen Abid, Zahid Vahora, Hossein Movahed, Sumyra Kachru, Rick Tee
Glenn Harvin, Eslam Ali, Amit Raina, William Leland, Brody School of Medicine at East Carolina University, Greenville, NC 27834, United States
Sabeen Abid, Zahid Vahora, Hossein Movahed, Sumyra Kachru, Rick Tee, Vidant Medical Center, Greenville, NC 27834, United States
Author contributions: All the authors contributed to the manuscript.
Institutional review board statement: The study was reviewed and approved by the East Carolina University and Vidant Medical Center Institutional Review Board.
Informed consent statement: Written informed consent was obtained from all the patients prior to study inclusion.
Conflict-of-interest statement: The authors have no potential conflict of interest.
Data sharing statement: Informed consent was not obtained for data sharing, and no additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Glenn Harvin, MD, Assistant Professor, Brody School of Medicine at East Carolina University, 521 Moye Boulevard, Greenville, NC 27834, United States. harving@ecu.edu
Telephone: +1-252-7445681 Fax: +1-252-8160801
Received: June 7, 2016
Peer-review started: June 12, 2016
First decision: July 11, 2016
Revised: July 29, 2016
Accepted: September 6, 2016
Article in press: September 8, 2016
Published online: November 16, 2016
Processing time: 161 Days and 2.9 Hours
Abstract
AIM

To discover the prevalence and the feasibility of screening for obstructive sleep apnea (OSA) in patients presenting for routine colonoscopy.

METHODS

Adult patients having a colonoscopy for routine indications at our outpatient endoscopy center were eligible if they did not carry a diagnosis of OSA or had not had a prior sleep study. All patients were administered the Berlin questionnaire prior to the procedure. Mallampati, neck circumference, height, weight, and BMI were obtained for each patient. Patients were observed for any drops in oxygen saturation < 92% or the presence of snoring for > 10 s. Patients were determined to be high-risk if they met at least 2 of the 3 symptom categories for the Berlin questionnaire.

RESULTS

A total of 60 patients were enrolled and completed the study; mean age was 56 years (range 23-72 year). Twenty-six patients had a positive Berlin questionnaire (43.3%), 31 patients had a negative Berlin questionnaire (51.6%) and 3 patients had an equivocal result (5.0%). Patients with a positive Berlin questionnaire were more likely to be of increased weight (mean 210.5 lbs vs mean 169.8 lbs, P = 0.003), increased BMI (33.0 kg/m2vs 26.8 kg/m2, P = 0.0016), and have an increased neck circumference (38.4 cm vs 35.5 cm, P = 0.012). Patients with a positive Berlin questionnaire were more likely to have a drop in oxygen saturation < 92% (76.9% vs 36.4%, P = 0.01). Patients with snoring were more likely to have a positive Berlin questionnaire (8/9 patients vs 1/31 patients with negative Berlin questionnaire; P = 0.0045).

CONCLUSION

Risk for OSA is extremely common in a population presenting for a routine colonoscopy, and screening at the time of a colonoscopy offers an excellent opportunity to identify these patients.

Keywords: Colonoscopy; Obstructive sleep apnea; Berlin questionnaire; Sedation; Screening

Core tip: We sought to determine the prevalence of patients at risk for obstructive sleep apnea (OSA) and the feasibility of screening patients for sleep apnea presenting for a routine colonoscopy to our outpatient endoscopy facility. All patients were screened for OSA with the Berlin questionnaire prior to the procedure. Overall, screening patients for sleep apnea at the time of a colonoscopy offers a unique opportunity not only to screen for colon cancer but also to identify patients at high risk for OSA who should undergo further testing.