Excessive daytime sleepiness and the risk for obstructive sleep apnea in Georgian population

Abstract

Excessive daytime sleepiness (EDS) is a common complaint in obstructive sleep apnea (OSA) patients. OSA, the most prevalent sleep breathing disturbance, is a risk-factor for various adverse health conditions. Epidemiological data on this subject in the Georgian population are scarce. The present study is aimed at investigating self-reported daytime sleepiness and the severity of sleep apnea risk in the population of the two largest cities of Georgia – Tbilisi and Kutaisi. 304 subjects from Tbilisi (mean age 37.07 + 10.73, 67.4% female) and 91 subjects from Kutaisi (39.4 + 10.8, 67.1% female) were surveyed. Participants completed Epworth sleepiness scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Beck depression inventory, short form (BDI SF). The risk of sleep apnea was screened using STOP BANG questionnaire (low risk – 0–2 positive answers; intermediate risk – 3–4 positive answers; high risk – 5 or more positive answers). Socio-demographic data and self evaluation of the overall health status were also obtained. EDS was defined as an ESS score ⩾11. Pearson chi-square tests were used to examine associations between OSA risk and sleep, health and socio-demographic variables. Group comparisons were conducted with unpaired t-test. Mean ESS score in the Tbilisi sample was 6.9 ± 3.8, and 19.7% had an EDS. These parameters were lower in the Kutaisi sample – 5.64 ± 3.54, and 7.7%. The between group differences in ESS score was statistically significant (t393 = 2.8, p = 0.005). Poor sleep quality was observed in 46.1% of Tbilisi sample (mean score 5.56 ± 3.13), and 33% of Kutaisi sample (4.52 ± 2.7). The significant correlation between sleep quality and BDI score was found in both groups. 7.9% of the Tbilisi and 4.4% of the Kutaisi sample had a high risk for OSA. 26% of the Tbilisi and 25.3% of the Kutaisi sample had an intermediate risk for OSA. In the Tbilisi population EDS and OSA severity were significantly associated with health status, sleep quality, BMI, age, gender and with EDS for OSA. In the Kutaisi sample, EDS was associated with health status, sleep quality and gender, and OSA severity was associated with EDS, age and gender. However, when the number of positive answers were checked the significant association was detected also with BMI ( p = 0.14). The findings point to poor sleep quality and a high prevalence of OSA risk in the Georgian population. Further studies are needed to determine the target subpopulation for OSA treatment. Study supported by Swiss National Science Foundation, SCOPES, grant IZ74Z0_137415