Risk of sedation for diagnostic esophagogastroduodenoscopy in obstructive sleep apnea patients

Table 1 Characteristics and baseline clinical data of subjects in the obstructive sleep apnea and control groups

	OSA group (n = 31)	Control group (n =65)	P value
Patient characteristics
Age (yr)	51.3 ± 9.6	47.1 ± 11.8	0.082
Sex (male)	23 (74.2)	27 (41.5)	0.003
Height (meters)	167.1 ± 6.8	164.4 ± 8.0	0.104
Weight (kg)	74.3 ± 11.2	62.6 ± 12.0	0.000
BMI (kg/m2)	26.5 ± 3.0	23.1 ± 3.3	0.000
Smoking	9 (29.0)	9 (13.8)	0.075
Drinking	11 (35.5)	24 (36.9)	0.891
Charlson score (points)	1.0 ± 0.2	1.0 ± 0.0	0.325
Hypertension	10 (32.3)	9 (13.8)	0.034
Diabetes mellitus	4 (12.9)	7 (10.8)	0.759
Baseline clinical data
Systolic BP (mmHg)	127.6 ± 16.9	114.3 ± 22.2	0.004
Diastolic BP (mmHg)	79.3 ± 10.6	66.1 ± 14.4	0.000
SaO2 (%)	97.6 ± 1.7	98.0 ± 2.2	0.418

Data are expressed as absolute n (%) or mean ± SD. OSA: Obstructive sleep apnea; BMI: Body mass index; BP: Blood pressure; SaO₂: Arterial oxygen saturation.

Table 2 Procedural characteristics and adverse events in the obstructive sleep apnea and control groups

	OSA group (n = 31)	Control group (n = 65)	P value
EGD data
Duration of EGD (s)	261.4 ± 79.6	304.4 ± 154.2	0.074
Midazolam dosage (mg)	5.3 ± 0.9	4.5 ± 0.8	0.000
MOAA/S score (points, at 2 min)	2.5 ± 1.2	2.9 ± 1.0	0.146
Level of sedation for EGD			0.024
Moderate sedation	13 (41.9)	43 (66.2)
Deep sedation	18 (58.1)	22 (33.8)
Adverse events
Sedation failure	0 (0.0)	0 (0.0)	-
Paradoxical responses	4 (12.9)	4 (6.2)	0.268
Snoring or apnea	5 (16.1)	7 (10.8)	0.458
Hypoxia (SaO2 < 90%)	1 (3.2)	7 (10.8)	0.211
Hypotension	0 (0.0)	0 (0.0)	-
Other adverse events	0 (0.0)	0 (0.0)	-
Oxygen administration	1 (3.2)	1 (0.2)	0.588
Flumazenil administration	0 (0.0)	0 (0.0)	-

Data are expressed as absolute n (%) or mean ± SD. OSA: Obstructive sleep apnea; EGD: Esophagogastroduodenoscopy; MOAA/S: Modified Observer’s Assessment of Alertness/Sedation; SaO₂: Arterial oxygen saturation.

Table 3 Multivariate logistic regression analysis of possible risk factors for a hypoxia

Parameter	OR (95%CI)	P value
Age (continuous)	1.056 (0.958-1.164)	0.276
Sex (female vs male)	1.003 (0.153-6.563)	0.997
Smoking (no vs yes)	0.753 (0.056-10.127)	0.830
Alcohol (no vs yes)	0.592 (0.095-3.706)	0.576
Diabetes mellitus (no vs yes)	1.842 (0.187-18.128)	0.601
Hypertension (no vs yes)	1.102 (0.120-10.117)	0.932
Body mass index (< 25 kg/m2vs≥ 25 kg/m2)	1.304 (0.192-8.845)	0.786
Midazolam dose (< 5 mg vs≥ 5 mg)	10.726 (0.815-141.100)	0.071
OSA (no vs yes)	0.117 (0.012-1.168)	0.068

OSA: Obstructive sleep apnea.