Comorbidities associated with obstructive sleep apnea: a retrospective Egyptian study on 244 patients
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The aim of the present study was to assess prevalence of associated comorbidities in a group of patients diagnosed with obstructive sleep apnea syndrome (OSAS).
This retrospective study enrolled 244 consecutive patients diagnosed by polysomnogram with OSAS between October 2010 and January 2015 after being referred to our Sleep-Related Breathing Disorders Unit, Chest Diseases Department, in the Alexandria Main University Hospital.
Of 244 patients, 47% were men, mean age was 56.9 years, and mean apnea–hypopnea index was 43.6 events per hour. Patients were categorized into two groups: group 1 (38%), mild and moderate OSAS, and group 2 (62%), severe, very severe, and extreme OSAS. Comorbidities were present in 91% of patients. The most common comorbidities were obesity, hypertension (HTN), and diabetes mellitus (DM). Prevalence of obesity, HTN, DM, congestive heart failure, deep vein thrombosis, pulmonary embolism (PE), and hypothyroidism was significantly higher in severity group 2. PE, bronchial asthma, and chronic obstructive pulmonary disease were significantly higher among men, whereas hypothyroidism was significantly higher among women. During this period of over 4 years, mortality rate was 8%. The majority of deaths occurred at night. Most of the studied patients (60%) either received no treatment or were not adherent to positive airway pressure (PAP) therapy. None of the patients received surgicaltreatment. The majority (50%) gained access to PAP therapy through donations. Associated hypoventilation was the only significant predictor of PAP adherence. Quality of life was significantly better among PAP adherent patients.
Patients suffering from OSAS have very high prevalence of comorbidities indicating a great burden on the healthcare system. Despite this fact, over 50% of the patients studied did not receive any treatment. Charities were the main portal fortreatment.
KeywordsSleep apnea Quality of life Morbidity Mortality Comorbidity PAP
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.Mohamed-Hussein AAR, Wafy S (2010) Prevalence and risk factors of obstructive sleep apnea syndrome in a population of upper Egypt. Eur Respir J 36: Suppl. 54, XXXsGoogle Scholar
- 3.World Health Organization. Division of Mental Health (1996) WHOQOL-BREF: introduction, administration, scoring and generic version of the assessment: field trial version, December 1996. World Health Organization, GenevaGoogle Scholar
- 4.Iber C, Ancoli-Israel S, Chesson AL Jr, Quan SF (2007) The AASMmanual for the scoring of sleep and associated events: rules, terminology and technical specifications, 1st edn. American Academy of Sleep Medicine, Westchester, ILGoogle Scholar
- 11.Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM et al (2016) American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract 3:1–203CrossRefGoogle Scholar
- 19.Celen YT, Hedner J, Carlson J, Peker Y (2010) Impact of gender on incident diabetes mellitus in obstructive sleep apnea: a 16-year follow-up. J Clin Sleep Med 6(3):244–250Google Scholar
- 21.Frost & Sullivan (2016) Hidden health crisis costing America billions. Underdiagnosing and undertreating obstructive sleep apnea draining healthcare system. Darien, IL: American Academy of Sleep Medicine. Available from: http://www.aasmnet.org/sleep-apnea-economic-impact.aspx