Abstract
PURPOSE: United Arab Emirates (UAE) is part of the GCC countries and ranks 18 on 2007 WHO list of the fattest countries with 68.3% of its citizens with an unhealthy weight. The WHO data in 2008 state that the prevalence of overweight in UAE is 71%, while it is 61% in the UK, 54% in Germany, and 45% in France. The increasing overweight and obesity in the UAE are closely related to high social-economic development. Accordingly, the medical authority has observed that the rates of hypertension and diabetes mellitus type 2 appear to be one of the highest rates worldwide. We presume that the increase prevalence of obesity in the UAE would be linked to the increase in prevalence of obstructive sleep apnea syndrome (OSAS). The purpose of this study is to estimate the prevalence of symptoms and risk of OSAS in women followed up in the primary health care (PHC) setting in Dubai and the relationship between obesity and sleep apnea in females in the UAE. DESIGN: Prospective observational community-based survey. SETTING: 20 primary health centers in Dubai. PARTICI-PANTS: Consecutive female patients who were older than 14 years, regardless of the reason of their visit. METHODS: In this prospective survey, trained medical nurse administered the Berlin Questionnaire (which includes questions about self-reported snoring, witnessed apneas, daytime sleepiness, hypertension, and obesity) to a consecutive random sample of female patients in the age group older than 14 years, attending the PHC center in Dubai Health Authority, Dubai, UAE, from September 2011 to March 2012. Based on the questionnaire, individuals were classified into high-risk and low-risk groups for OSAS. RESULTS: Based on the responses and measurement of the Berlin Questionnaire of 704 female subjects studied, 137 respondents met the criteria for the high-risk scoring. This gives a prevalence rate of 19.5% while the remainders of the participants were classified as low risk. The overall mean age of the high risk for OSAS female respondents was 39.95 ± 11.73 years. The highest prevalence was noticed between age group 51 to 60 years. 70% of the high risk group patients had Body Mass Index (BMI) ≥30 kg/m2 and nearly 75% of the low risk group had BMI 2 and the Mean BMI was 33.59 ± 6.44 kg/m2. CONCLUSIONS: One in five women in Dubai, UAE is at high risk of having OSAS. Awareness by the primary care medical community about this disorder in females should be increased so that the patients would benefit from proper evaluation and treatment of OSAS.
Highlights
Obstructive sleep apnea syndrome (OSAS) is a sleep disorder characterized by snoring, repetitive pauses of breathing which can last from at least 10 seconds to minutes leading to sleep fragmentation, excessive daytime sleepiness, fatigue, and impaired cognition
Demographics and frequency distribution of age 704 female respondents were included in this analysis based on the responses and measurement of the Berlin Questionnaire of these subjects
Our study revealed a close association between high Body Mass Index (BMI) and the risk of OSAS in the population of Dubai, among obese subjects (BMI ≥ 30 kg/m2) 70% were at high risk of OSAS and nearly 75% of the low risk group have BMI < 30 kg/m2, which indicates obesity is a very strong predictor of OSAS risk in Dubai
Summary
Obstructive sleep apnea syndrome (OSAS) is a sleep disorder characterized by snoring, repetitive pauses of breathing which can last from at least 10 seconds to minutes leading to sleep fragmentation, excessive daytime sleepiness, fatigue, and impaired cognition. These symptoms may present for years without identification as the sufferer may become conditioned to these symptoms. The most common cause of OSAS is the partial or complete stoppage of the flow of air due to the relaxation of the muscles which surround the throat and tongue and vary greatly among individuals and may vary considera- OPEN ACCESS. Examining the entire sleep apnea spectrum may decrease the difference in prevalence of OSAS between males and females to 1.5:1. It was estimated that more than 90% of women with sleep apnea may be under diagnosed
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