Pinto Ashna M, Devaraj Uma, Ramachandran Priya, Joseph Bobby, D'Souza George A
Department of Pulmonary and Sleep Medicine, St. John's Medical College, Bengaluru, Karnataka, India.
Department of Community Medicine, St. John's Medical College, Bengaluru, Karnataka, India.
Lung India. 2018 Jul-Aug;35(4):301-306. doi: 10.4103/lungindia.lungindia_433_17.
To estimate the occurrence of obstructive sleep apnea (OSA) and its risk factors in a rural Indian population using screening questionnaire and Level III sleep study. To determine the feasibility to train community health workers to administer Level III sleep study in the high-risk population.
The study was conducted from seven villages with adult population of 2247, in Mugalur, near Bengaluru, from January to April 2014. Berlin questionnaire was used to screen 321 participants chosen by stratified random sampling. A total of 26 out of 321 patients underwent Level III sleep study at home, administered by the health workers, who were trained in three sessions to hook up the machine. Data were verified by a certified sleep physician.
The mean age was 39.43 ± 15.6 years with the M:F ratio of 0.98:1. Prevalence of risk of OSA by Berlin questionnaire was 8.72% (95% confidence interval [CI] 5.63, 11.81) in the total population, 7.4% in males and 11.7% in females. Older age (odds ratio [OR] 3.97; CI 1.63, 9.6), hypertension (OR 11; CI 4.3, 28.2), obesity (OR 2.35; CI 1, 5.5), and higher Mallampati score (OR 3.78; CI 1.7, 8.4) were significantly associated with high risk of OSA (P = 0.0001-0.04). Twenty-six patients underwent Level III sleep study and OSA was diagnosed in 12 patients. The mean apnea-hypopnea index (AHI) of this group was 9.7/h. The prevalence of OSA by AHI criteria was 3.74%.
OSA is underdiagnosed in rural populations, although risk factors are present. Training community health workers to administer Level III sleep study is a feasible and cost-effective strategy.
使用筛查问卷和三级睡眠研究来估计印度农村人口中阻塞性睡眠呼吸暂停（OSA）的发生率及其风险因素。确定培训社区卫生工作者在高危人群中进行三级睡眠研究的可行性。
2014年1月至4月，在班加罗尔附近的穆加卢尔的7个村庄进行了该研究，这些村庄的成年人口为2247人。使用柏林问卷对通过分层随机抽样选择的321名参与者进行筛查。321名患者中有26名在家中接受了由卫生工作者进行的三级睡眠研究，这些卫生工作者经过了三个阶段的培训以连接设备。数据由一名认证的睡眠医生进行核实。
平均年龄为39.43±15.6岁，男女比例为0.98:1。根据柏林问卷，总体人群中OSA风险的患病率为8.72%（95%置信区间[CI]5.63，11.81），男性为7.4%，女性为11.7%。年龄较大（比值比[OR]3.97；CI 1.63，9.6）、高血压（OR 11；CI 4.3，28.2）、肥胖（OR 2.35；CI 1，5.5）和较高的马兰帕蒂评分（OR 3.78；CI 1.7，8.4）与OSA的高风险显著相关（P = 0.0001 - 0.04）。26名患者接受了三级睡眠研究，其中12名被诊断为OSA。该组的平均呼吸暂停低通气指数（AHI）为9.7/h。根据AHI标准，OSA的患病率为3.74%。
尽管存在风险因素，但农村人群中的OSA未得到充分诊断。培训社区卫生工作者进行三级睡眠研究是一种可行且具有成本效益的策略。
