Singh Abhijeet, Prasad Rajendra, Garg Rajiv, Kant Surya, Hosmane Giridhar B, Dubey Abhisek, Agarwal Abhisek, Verma Ram Kishun
King George Medical University, Lucknow.
Monaldi Arch Chest Dis. 2017 May 18;87(1):773. doi: 10.4081/monaldi.2017.773.
Obstructive Sleep Apnea Syndrome (OSAS) has been recognised as a major cause of morbidity and mortality in developing countries like India. There is still a paucity of Indian studies regarding the prevalence of OSAS. The current single centre prospective cross-sectional study was undertaken to know prevalence estimates for key symptoms and features that can indicate the presence of OSAS in an Indian population. A survey was conducted on subjects with age groups ≥ 25 years at King George's Medical University, Lucknow, Uttar Pradesh, India from August 2009 to July 2011. Data was recorded during the interview on the basis of Berlin Questionnaire (BQ). Risk factors for OSAS were also evaluated. Risk group categorization for OSAS was done with the help of a questionnaire and overnight polysomnography was performed in each group to measure apnea and hypopnea index (AHI). Out of 1816 subjects, 1512 (response rate 83.3%) finally participated in the survey with mean age 42.6±11.2 years, males 67.9% and females 32.1%. Of them 6.2% were found to be at high-risk OSAS; 12.2% were obese (Body Mass Index ≥30 kg/m2) and 33.5% of the obese population were at high-risk OSAS. Among high-risk patients with OSAS, 62.4% had hypertension. Statistically significant and independent risk factors found for OSAS were obesity, large neck size, alcoholism and use of sedatives/tranquillizers. High-risk category predicted an AHI ≥5 with a sensitivity of 86.3% (95% CI 73.1-93.8), specificity of 93.1% (95% CI 89.1-95.7), positive and negative predictive values of 70.9% (95% CI 57.9-81.4) and 97.2% (95% CI 94.1-98.8) respectively. It can be concluded that BQ questionnaire can still be used as a pre-assessment tool for predicting persons at risk for OSAS in clinical practice. Further studies on estimation of prevalence of OSAS by applying BQ are warranted in near future from other regions of India.
阻塞性睡眠呼吸暂停综合征（OSAS）已被公认为是印度等发展中国家发病和死亡的主要原因。关于OSAS患病率的印度研究仍然匮乏。当前这项单中心前瞻性横断面研究旨在了解印度人群中可提示OSAS存在的关键症状和特征的患病率估计值。2009年8月至2011年7月，在印度北方邦勒克瑙市乔治国王医学院对年龄≥25岁的受试者进行了一项调查。根据柏林问卷（BQ）在访谈期间记录数据。还评估了OSAS的危险因素。借助问卷对OSAS进行风险组分类，并对每组进行夜间多导睡眠图检查以测量呼吸暂停低通气指数（AHI）。在1816名受试者中，1512名（应答率83.3%）最终参与了调查，平均年龄42.6±11.2岁，男性占67.9%，女性占32.1%。其中，6.2%被发现处于OSAS高风险；12.2%肥胖（体重指数≥30kg/m²），且33.5%的肥胖人群处于OSAS高风险。在OSAS高风险患者中，62.4%患有高血压。发现OSAS具有统计学意义的独立危险因素为肥胖、颈围大、酗酒以及使用镇静剂/ tranquilizers（原文此处可能有误，推测为tranquilizers）。高风险类别预测AHI≥5，敏感性为86.3%（95%置信区间73.1 - 93.8），特异性为93.1%（95%置信区间89.1 - 95.7），阳性预测值和阴性预测值分别为70.9%（95%置信区间57.9 - 81.4）和97.2%（95%置信区间94.1 - 98.8）。可以得出结论，在临床实践中，BQ问卷仍可作为预测OSAS风险人群的预评估工具。近期有必要从印度其他地区开展关于应用BQ评估OSAS患病率的进一步研究。
