Prevalence, Risk Factors and Clinical Manifestation of Patients Suspected as having Obstructive Sleep Apnea in Songklanagarind Hospital Sleep Center

Krongthong Tawaranurak; Peesit Leelasawatsuk; Varaned Chaiyarukjirakun

doi:10.31584/jhsmr.201965

Prevalence, Risk Factors and Clinical Manifestation of Patients Suspected as having Obstructive Sleep Apnea in Songklanagarind Hospital Sleep Center

Krongthong Tawaranurak, Peesit Leelasawatsuk, Varaned Chaiyarukjirakun

Abstract

Objective: To identify the prevalence and to determine both risk factors and clinical manifestation of obstructive sleep apnea (OSA).
Material and Methods: A retrospective study was conducted to review the medical records and polysomnographic data of patients from March 2006 to December 2017.
Results: A total of 929 patients was enrolled, however, only 124 patients had habitual snoring (13.4%). The prevalence of OSA and OSAS was 85.6% and 52.7% respectively. OSA was more prevalent in men than women (60.5% vs 25.1%). The presence of HT or symptoms of choking, gasping and neurocognitive impairment were significantly greater in OSA patients compared with the non-OSA group. In multivariate analysis, it was revealed that male gender, age ≥50 years, body-mass index (BMI) >25 kg/m2, neck circumference (NC) >40 cm and waist to height ratio (WHtR) >0.6 were the significant predictors for OSA.
Conclusion: This study demonstrated that; OSA is a major health concern within the Thai population. Male gender, elderly age and those higher in BMI, NC or WHtR can be predicted as having the presence of OSA.

Keywords

obstructive sleep apnea; polysomnography; prevalence; risk factor

Full Text:

PDF

References

Jennum P, Riha RL. Epidemiology of sleep apnoea/hyponoea syndrome and sleep-disordered breathing. Eur Respir J 2009;33:907-14.

Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993;328:1230-5.

Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J

Respir Crit Care Med 2002;165:1217-39.

George CF. Sleep apnea, alertness, and motor vehicle crashes. Am J Respir Crit Care Med 2007;176:954-6.

Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 2000;342:1378-84.

Nieto FJ, Young TB, Lind BK, Shahar E, Samet JM, Redline S, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA 2000;283:1829-36.

Ip MS, Lam B, Ng MM, Lam WK, Tsang KW, Lam KS. Obstructive sleep apnea is independently associated with insulin resistance. Am J Respir Crit Care Med 2002;165:670-6.

Redline S, Yenokyan G, Gottlieb DJ, Shahar E, O’Connor GT, Resnick HE, et al. Obstructive sleep apnea-hypopnea and incident stroke: the sleep heart health study. Am J Respir Crit Care Med 2010;182:269-77.

Marshall NS, Wong KK, Liu PY, Cullen SR, Knuiman MW, Grunstein RR. Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study. Sleep 2008;31:1079-85.

Young T, Finn L, Peppard PE, Szklo-Coxe M, Austin D, Nieto FJ, et al. Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep 2008;31:1071-8.

Young T, Shahar E, Nieto FJ, Redline S, Newman AB, Gottlieb DJ, et al. Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study. Arch Intern Med 2002;162:893-900.

Young T, Skatrud J, Peppard PE. Risk factors for obstructive sleep apnea in adults. JAMA 2004;291:2013-6.

Ibrahim AS, Almohammed AA, Allangawi MH, A Sattar HA, Mobayed HS, Pannerselvam B, et al. Predictors of obstructive sleep apnea in snorers. Ann Saudi Med 2007;27:421-6.

Lee RW, Vasudavan S, Hui DS, Prvan T, Petocz P, Darendeliler MA, et al. Differences in craniofacial structures and obesity in Caucasian and Chinese patients with obstructive sleep apnea. Sleep 2010;33:1075-80.

Li KK, Kushida C, Powell NB, Riley RW, Guilleminault C. Obstructive sleep apnea syndrome: a comparison between far-east Asian and white men. Laryngoscope 2000;110:1689-93.

Mirrakhimov AE, Sooronbaev T, Mirrakhimov EM. Prevalence of obstructive sleep apnea in Asian adults: a systematic review of the literature. BMC Pulm Med 2013;13:10.

Neruntarat C, Chantapant S. Prevalence of sleep apnea in HRH Princess Maha Chakri Sirindhorn Medical Center, Thailand. Sleep Breath 2011;15:641-8.

Friedman M, Hamilton C, Samuelson CG, Lundgren ME, Pott T. Diagnostic value of the Friedman tongue position and Mallampati classification for obstructive sleep apnea: a meta-analysis. Otolaryngol Head Neck Surg 2013;148:540-7.

Berry RB, Brooks R, Gamaldo CE, Harding SM, Lloyd RM, Quan SF, et al. The AASM manual for the scoring of sleep

and associated events: rules, terminology and technical specifications, version 2.4. Darien, IL: American Academy of Sleep Medicine; 2017.

Banhiran W, Assanasen P, Nopmaneejumruslers C, Metheetrairut C. Epworth sleepiness scale disordered breathing: the reliability and validity of the Thai version. Sleep Breath 2011;15:571-7.

Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991;14:540-5.

Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, et al. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med 2017;13:479-504.

Frey WC, Pilcher J. Obstructive sleep-related breathing disorders in patients evaluated for bariatric surgery. Obes Surg 2003;13:676-83.

O’Keeffe T, Patterson EJ. Evidence supporting routine polysomnography before bariatric surgery. Obes Surg 2004;14:23-6.

Musman S, Passos VM, Silva IB, Barreto SM. Evaluation of a prediction model for sleep apnea in patients submitted to polysomnography. J Bras Pneumol 2011;37:75-84.

Chung F, Abdullah HR, Liao P. STOP-Bang Questionnaire: a practical approach to screen for obstructive sleep apnea. Chest 2016;149:631-8.

Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 2013;177:1006-14.

Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev 2012;13:275-86.

Jayawardana R, Ranasinghe P, Sheriff MH, Matthews DR, Katulanda P. Waist to height ratio: a better anthropometric marker of diabetes and cardio-metabolic risks in South Asian adults. Diabetes Res Clin Pract 2013;99:292-9.

Ahbab S, Ataoglu HE, Tuna M, Karasulu L, Cetin F, Temiz LU, et al. Neck circumference, metabolic syndrome and obstructive sleep apnea syndrome; evaluation of possible linkage. Med Sci Monit 2013;19:111-7.

Borel AL, Coumes S, Reche F, Ruckly S, Pépin JL, Tamisier R, et al. Waist, neck circumferences, waist-to-hip ratio: Which is the best cardiometabolic risk marker in women with severe obesity? The SOON cohort. Plos One 2018;13: e0206617.

International Diabetes Institute, World Health Organization. The Asia-Pacific perspective: redefining obesity and its treatment. Melbourne: Health Communications Australia; 2000.

DOI: http://dx.doi.org/10.31584/jhsmr.201965

Refbacks

There are currently no refbacks.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.