Prevalence of Sleep Disordered Breathing in an African General Population: The Benin Society and Sleep (BeSAS) Study

Abstract

Background: There are currently no data on the prevalence of sleep-disordered breathing (SDB) in the African general population. This study aimed to objectively determine the prevalence of, and factors associated with, SDB in a large population-based sample in Benin, West Africa. Methods: The Benin Society and Sleep (BeSAS) population-based study was conducted from April 2018 to January 2021. Participants were recruited from both urban and rural areas. Subjects underwent polygraphy at home using a type III device. Clinical and morphometric data were also collected. SBD severity categories were defined according to apnoea-hypopnoea index (AHI): mild-to-severe (AHI ≥5/h, moderate-to-severe (AHI ≥15/h) or severe (AHI ≥30/h). Findings: For the 1810 participants with complete polygraphic data (age 46±15 years, 64·2% women), the prevalence (95% confidence interval [CI]) of mild-to-severe SDB (AHI ≥5/h) was 43·2% (40·9–45·5), of moderate-to-severe SDB (AHI ≥15/h) was 11·6% (10·2–13·1), and of severe SDB (AHI ≥30/h) was 2·7% (2·0-3·5). Factors independently associated with SBD were advanced age, large neck circumference, and snoring in both sexes. After multivariable adjustment, severe SDB was independently associated with hypertension (odds ratio 3·99 [95% CI 1·04–15·33]; p trend =0·044) in women but not in men. Interpretation: The BeSAS study provides the first objective evaluation of SDB prevalence and associated factors in Africa. The high prevalence of SDB identified should stimulate the development of public health policies to prevent and treat this condition in African countries. Funding Information: Ligue Pulmonaire Vaudoise, Switzerland. Declaration of Interests: RH is member of the medical advisory board of Dreem and Nightbalance (Philips) and received honorariums, grants or speakers’ fees from ResMed, Jazz, Inspire, Philips and Dreem. All the other authors have no conflict of interest to disclose. Ethics Approval Statement: The study was approved by the National Ethics Committee of Benin (reference No. 45, 25 October 2017) with regular annual approval renewal throughout the course of the research project. Participants were enrolled on a voluntary basis and provided written informed consent. If a subject was unable to read or write, a family member able to read was asked to assist with providing information.