Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo-UNIFESP, São Paulo, Brazil.
PLoS One. 2012;7(2):e30085. doi: 10.1371/journal.pone.0030085. Epub 2012 Feb 1.
The aim of this study was to investigate whether insomnia and obstructive sleep apnea (OSA) were predictors of hospitalizations or emergency department visits during two years following the Sao Paulo Epidemiologic Sleep Study (EPISONO) sample.
All participants (n = 1,101) who underwent a baseline evaluation between July and December 2007 were contacted in December 2009 and asked to fill out a questionnaire about body weight changes, number of hospitalizations and visits to the emergency department. Participants lost during the follow-up period represented 3.2% (n = 35) and 7 subjects had died. Hospitalizations were reported by 116 volunteers (10.5%) and emergency department visits were reported by 136 participants (12.4%). The average body mass index (BMI) did not vary significantly between the first and the second assessment [26.7(95%CI:26.3-27.1) vs. 26.9(26.5-27.4) kg/m2]. After adjusting for confounders, a multiple logistic regression model revealed that female gender [1.4(1.0-1.9)], age ≥ 40 years, insomnia diagnosed according to the DSM-IV criteria [1.6(1.0-2.6)], and apnea-hypopnea index ≥ 15 [1.5(1.0-2.2)] were predictors of hospitalizations and/or demand for emergency services.
Our study of a probabilistic sample of the Sao Paulo inhabitants shows that over a period of two years, insomnia and OSA were both associated with health impairment. Considering the high prevalence and public health burden of sleep disorders, the consequences of untreated disease for both the individual and society are undeniable and should be addressed.
本研究旨在调查失眠和阻塞性睡眠呼吸暂停（OSA）是否可预测圣保罗流行病学睡眠研究（EPISONO）样本随访 2 年内的住院或急诊就诊情况。
所有于 2007 年 7 月至 12 月进行基线评估的参与者（n=1101）均于 2009 年 12 月被联系并要求填写一份关于体重变化、住院和急诊就诊次数的问卷。在随访期间失访的参与者占 3.2%（n=35），其中 7 人死亡。116 名志愿者（10.5%）报告了住院情况，136 名参与者（12.4%）报告了急诊就诊情况。第一次和第二次评估的平均体重指数（BMI）没有明显差异[26.7（95%CI：26.3-27.1）vs. 26.9（26.5-27.4）kg/m2]。调整混杂因素后，多因素逻辑回归模型显示，女性[1.4（1.0-1.9）]、年龄≥40 岁、根据 DSM-IV 标准诊断的失眠[1.6（1.0-2.6）]和呼吸暂停低通气指数≥15[1.5（1.0-2.2）]是住院和/或急诊服务需求的预测因素。
我们对圣保罗居民的概率样本进行的研究表明，在两年的时间内，失眠和 OSA 均与健康受损有关。考虑到睡眠障碍的高患病率和对公共卫生的负担，未治疗疾病对个人和社会的后果是不可否认的，应加以解决。
