Identifying patients at high risk for obstructive sleep apnoea syndrome in Nigeria: A multicentre observational study|
Desalu, Olufemi O.; Onyedum, Cajetan C.; Adeoti, Adekunle O.; Fadare, Joseph O.; Sanya, Emmanuel O.; Fawale, Michael B. & Bello, Hamzat A.
Obstructive sleep apnoea is associated with significant health consequences. A significant proportion of hospitalised patients at risk
for obstructive sleep apnoea were never identified and referred for polysomnography for diagnosis. The objective of this study was to
determine the factors associated with high risk for obstructive sleep apnoea and use it to identify patients at risk for the condition in
tertiary hospitals in Nigeria.
This was a multicentre observational study of adult patients hospitalised in 3 selected hospitals from 15th January to 17th March 2015.
Berlin questionnaire and Epworth sleepiness scale were used to assess for obstructive sleep apnoea risk and excessive daytime sleepiness
respectively. Additional questions on traditional risk factors for obstructive sleep apnoea were also obtained.
Nine hundred and twenty-six patients were recruited into the study. Respondents’ mean age was 44.3 years ± 15.2 years, 486 (52.5%)
were females and 556 (60.0%) had 1 or more medical comorbidity and none of the patients had a previous diagnosis of obstructive sleep
apnoea. Factors that were independently associated with high risk for obstructive sleep apnoea include systemic hypertension (OR =
10.33; 95% CI = 6.42 to 16.61), obesity (OR = 7.87; 95% CI = 4.33 to 14.29), excessive daytime sleepiness (OR = 3.77; 95% CI = 2.28
to 6.22), tobacco smoking (OR = 2.99; 95% CI = 1.76 to 5.07), snoring in a first-degree relative (OR = 1.83; 95% CI = 1.19 to 2.81), and
the use of sedative (OR = 1.82; 95% CI = 1.06 to 3.15).
This study shows that patients with systemic hypertension, obesity, excessive daytime sleepiness, history of smoking, snoring in a first-degree
relative and use of sedatives are at high risk of obstructive sleep apnoea. None of the patients at high risk had a previous diagnosis
of sleep apnoea by a physician, highlighting the diagnostic challenges of this condition. The results of this study will assist health care
professionals in early identification of individuals at risk of obstructive sleep apnoea and subsequent referral for a sleep study.