Factors affecting the severity of the apnea hypoapnea index: a retrospective study on 838 Egyptian patients diagnosed with obstructive sleep apnea

Ahmed Gharib,Shahira Loza

doi:10.1186/s43168-020-00034-x

Ahmed Gharib, Shahira Loza

Open Access

https://doi.org/10.1186/s43168-020-00034-x

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Abstract

BackgroundObstructive sleep apnea (OSA) is a common condition in the general population that is highly correlated to obesity, and it is associated with major cardiovascular morbidity and mortality. In Egypt, obesity rates are known to be high; however, OSA remains largely under-diagnosed, and data on its current magnitude is very scarce. Thus, the aims of the study were to identify the percentage of OSA in a large sample of patients referred for polysomnography and to determine the effect of different demographic data on the severity of the disease.ResultsThis retrospective study included 1012 patients. Medical data were reviewed by sleep specialists. The correlation between age, body mass index (BMI), and neck circumference (NC) with apnea hypoapnea index (AHI) was explored. Also, gender differences were analyzed. A total of 838 patients (81% males, 19% females) were diagnosed with OSA. Patients with mild, moderate, and severe OSA were 204 (24%), 146 (17%), and 488 (58%), respectively. Females were older than males (58.87 ± 10.25 versus 54.39 ± 22.96, p = 0.001) and BMI was not significantly different between both sexes (34.18 ± 13.53 versus 36.73 ± 23.25, p = 0.07), but NC was higher in men (43.56 ± 5.3 versus 39.34 ± 4.41, p = 0.001). AHI was significantly increased in men compared to women (47.97 ± 31.22 versus 37.95 ± 31.72, p = 0.001) and severe OSA was commonly diagnosed in men than women (p = 0.001). A positive significant correlation was found between BMI, NC with AHI, arousal index, average SpO2, and desaturation index.ConclusionOSA is highly prevalent among our patients. Additionally, BMI and NC independently affected the severity of their disease.

Highlights

Obstructive sleep apnea (OSA) is a common condition in the general population that is highly correlated to obesity, and it is associated with major cardiovascular morbidity and mortality
Patients The diagnosis of OSA was established in 838 (83%) of the 1012 patients referred to our center for polysomnography evaluation
Differences between mild, moderate, and severe OSA We found a highly significant difference between patients with mild, moderate, and severe OSA as regards the body mass index (BMI), neck circumference (NC), Epworth Sleepiness Scale (ESS), arousal index (AI), Peripheral capillary oxygen saturation (SpO2), and the desaturation index (DI) (p = 0.001)

Summary

Introduction

Obstructive sleep apnea (OSA) is a common condition in the general population that is highly correlated to obesity, and it is associated with major cardiovascular morbidity and mortality. The prevalence of OSA, even though still underdiagnosed, has been investigated in different Western population cohorts, varying around 34% for men and 17% for women [3]. This incidence of OSA is expected to rise even more with the explosion of the obesity epidemics around the world [4]. OSA is a known risk factor for many comorbid disorders, causing resistance to conventional treatments and increasing the risk of mortality, which multiplies health care expenditures [8, 9], and even though the distribution of comorbidities differs between men and women, their effect progressively increases with OSA severity [10]. A Danish study concluded that male gender, age, and continuous positive airway pressure (CPAP) treatment were the predictor variables for quality of life and survival in patients with OSA [11]

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