Correlation Between Epworth Score and Neck Circumference in Pakistani Adults: A Cross-Sectional Study

Abstract

Background: Obstructive sleep apnea (OSA) is a sleep disorder that causes airflow to stop or significantly decrease when breathing is being performed. Although neck circumference (NC) measurements are recognised as markers of obesity, they are rarely investigated as a component of OSA scoring systems. The Epworth sleepiness scale (EPSS) is a way of measuring how likely a person is to fall asleep during the daytime. Objective: To determine the correlation between Epworth score and neck circumference in Pakistani adults, in terms of an increase in neck circumference indicates a significant risk of OSA. Study Design: Cross-sectional study. Settings: Pulmonary Vascular and Sleep Disorders department of Dow University Hospital, Karachi Pakistan. Duration: The study duration was 6 months from June 2021 to December 2021. Methods: All the cases suspected of having obstructed sleep apnoea (OSA) aged between 18 and 60 years of either gender were included. Information about obstructed sleep apnoea was collected from the patient's family members, and some patients were interrogated with questioning. In ESS, the proforma is calculated for each individual with obstructed sleep apnoea in accordance with the proforma's requirements. Neck circumference was assessed in the middle of the neck, between the mid-cervical spine and the mid-anterior neck by using non-stretchable plastic tape. All the data was collected via study proforma. SPSS version 26 was used for the data analysis. Results: A total of 184 cases were studied suspected of OSA, their mean age was 51.84 ± 12.24 years. Males were in the majority, 57.6%. Overall neck circumference was 43.39 ± 3.58 cm and the mean Epworth score was 13.83 ± 4.93. There was a positive correlation between neck circumference and Epworth score in the Pakistani population. Raised neck circumference was found to be significantly associated with the high degree Epworth score (p-0.007) in males, and raised neck circumference was found to be statistically insignificant (p-0.119) in females. Conclusion: According to the findings of the study, an increasing neck circumference was found to have a positive correlation with an increasing severity of Epworth score in the population of Pakistan. This suggests that a population with an increased neck circumference is at a high risk, particularly males, who have an increased risk in comparison to females.