Department of Chest Diseases, Faculty of Medicine, University of Alexandria, 26 Mostafa kamel officer buildings, Alexandria, Egypt.
Department of Public, Preventive and Social Medicine, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.
Sleep Breath. 2019 Dec;23(4):1079-1085. doi: 10.1007/s11325-019-01783-w. Epub 2019 Jan 26.
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.
本研究旨在评估一组诊断为阻塞性睡眠呼吸暂停综合征(OSAS)患者的合并症患病率。
这是一项回顾性研究,共纳入 244 例 2010 年 10 月至 2015 年 1 月期间因 OSAS 被转诊至亚历山大大学总医院胸部疾病科睡眠相关呼吸障碍科行多导睡眠图检查的患者。
244 例患者中,47%为男性,平均年龄为 56.9 岁,平均呼吸暂停低通气指数为 43.6 次/小时。患者分为两组:组 1(38%)为轻中度 OSAS,组 2(62%)为重度、极重度和极度 OSAS。91%的患者存在合并症。最常见的合并症为肥胖、高血压(HTN)和糖尿病(DM)。在严重程度组 2 中,肥胖、HTN、DM、充血性心力衰竭、深静脉血栓形成、肺栓塞(PE)和甲状腺功能减退症的患病率显著更高。PE、支气管哮喘和慢性阻塞性肺疾病在男性中显著更高,而甲状腺功能减退症在女性中显著更高。在超过 4 年的时间里,死亡率为 8%。大多数死亡发生在夜间。大多数研究患者(60%)未接受治疗或未坚持使用正压通气(PAP)治疗。没有患者接受手术治疗。大多数患者(50%)通过捐赠获得 PAP 治疗。合并性低通气是 PAP 依从性的唯一显著预测因子。PAP 依从性患者的生活质量显著更好。
患有 OSAS 的患者合并症患病率非常高,这对医疗保健系统构成了巨大负担。尽管如此,超过 50%的研究患者未接受任何治疗。慈善机构是治疗的主要渠道。