Abstract
BackgroundObstructive sleep apnea (OSA) is an increasingly common disorder associated with increased cardiovascular disease, mortality, reduced productivity, and an increased risk of road traffic accidents. A significant proportion of patients with OSA in the UK are undiagnosed. This study aims to identify risk factors for OSA in an obese cohort.MethodA population-based study was conducted of obese patients (BMI ≥ 30 kg/m2) from the Clinical Practice Research Datalink (CPRD). A logistic regression model was used to calculate odds ratios (ORs) for developing OSA according to other clinicopathological characteristics. Multivariate analysis was conducted of individual factors that affect the propensity to develop OSA. Statistical significance was defined as p < 0.050.ResultsFrom 276,600 obese patients identified during a data extraction of the CPRD in July 2017, the prevalence of OSA was 5.4%. The following risk factors were found to be independently associated with increased likelihood of OSA: male sex (OR = 3.273; p < 0.001), BMI class II (OR = 1.640; p < 0.001), BMI class III (OR = 3.768; p < 0.001), smoking (OR = 1.179; p < 0.001), COPD (OR = 1.722; p < 0.001), GERD (OR = 1.557; p < 0.001), hypothyroidism (OR = 1.311; p < 0.001), acromegaly (OR = 3.543; p < 0.001), and benzodiazepine use (OR = 1.492; p < 0.001). Bariatric surgery was associated with reduced risk of OSA amongst this obese population (OR = 0.260; p < 0.001).ConclusionsIn obese patients, there are numerous comorbidities that are associated with increased likelihood of OSA. These factors can help prompt clinicians to identify undiagnosed OSA. Bariatric surgery appears to be protective against developing OSA.
Highlights
Obstructive sleep apnea (OSA) is the most common cause of sleep-disordered breathing and is estimated to affect a significant population of men (37%) and women (50%) [1, 2]
There was a significant difference in mean age between obese patients with (61.3 ± 13.8) or without (61.0 ± 16.7; p = 0.035) a diagnosis of OSA. 59.8% (n = 8477) of the patients diagnosed with OSA were male, compared to 35.2% (n = 92,271; p < 0.001) of patients without OSA
The following risk factors were found to be independently associated with increased likelihood of OSA: male sex (OR = 3.273; 95% confidence intervals (95%CI) 3.154–3.396; p < 0.001), BMI class II (OR = 1.640; 95%CI 1.556–1.739; p < 0.001), BMI class III (OR = 3.768; 95%CI 3.539–3.955; p < 0.001), hypertension (OR = 1.174; 95%CI 1.130–1.220; p < 0.001), diabetes mellitus (OR = 1.343; 95%CI 1.292–1.395; p < 0.001), hyperlipidemia (OR = 1.157; 95%CI 1.099–1.219; p < 0.001), smoking (OR = 1.179; 95%CI 1.138–1.223; p < 0.001), chronic obstructive pulmonary disease (COPD) (OR = 1.722; 95%CI 1.622–1.828; p < 0.001), gastro-esophageal reflux disease (GERD) (OR = 1.557; 95%CI 1.493–1.625; p < 0.001), hypothyroidism (OR = 1.311 95%CI 1.239–1.387; p < 0.001), acromegaly (OR = 3.543; 95%CI 2.108–5.956; p < 0.001), and benzodiazepine use
Summary
Obstructive sleep apnea (OSA) is the most common cause of sleep-disordered breathing and is estimated to affect a significant population of men (37%) and women (50%) [1, 2]. Obesity is associated with increased yearly incidence of OSA, with obese patients affected by more severe disease [2, 7]. Obesity is a well-established risk factor for the development and progression of OSA, with increasing adiposity associated with a marked risk of developing OSA [7, 8]. Obstructive sleep apnea (OSA) is an increasingly common disorder associated with increased cardiovascular disease, mortality, reduced productivity, and an increased risk of road traffic accidents. This study aims to identify risk factors for OSA in an obese cohort. Conclusions In obese patients, there are numerous comorbidities that are associated with increased likelihood of OSA. These factors can help prompt clinicians to identify undiagnosed OSA.
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