Chami Hassan A, Bechnak Amer, Isma'eel Hussain, Talih Farid, Nasreddine Lara, Nasrallah Mona, Tamim Hani
Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon.
J Clin Sleep Med. 2019 Apr 15;15(4):603-614. doi: 10.5664/jcsm.7724.
The prevalence of sleep disorders in the Lebanese population is unknown. We assessed the prevalence of insomnia and sleep apnea risk and examined their relationship with sociodemographic, lifestyle, and health characteristics in a sample from Greater Beirut.
This cross-sectional pilot survey included 501 adults from the community (age 45.2 ± 15.2 years, 64% females). Insomnia symptoms, insomnia disorder, and sleep apnea risk were assessed using the Sleep Heart Health Study and Berlin Questionnaire. Characteristics were compared between individuals with and without insomnia symptoms, insomnia disorder, and sleep apnea. Correlates were assessed using multivariate regression.
A total of 44.5% of participants reported insomnia symptoms > 15 nights/mo and 34.5% reported insomnia. Predictors of insomnia symptoms and disorder included female sex (odds ratio [OR] 1.51, 95% confidence interval [CI] 1.01-2.27 and OR 1.76, 95% CI 1.13-2.75, respectively), education level below high school (OR 1.96, 95% CI 1.31-2.95 and OR 2.40, 95% CI 1.52-3.77, respectively) and medical comorbidities (OR 2.27, 95% CI 1.30-3.95 and OR 3.02, 95% CI 1.3-5.27, respectively). Although 31% of participants were at high risk for sleep apnea, only 5% received the diagnosis from a physician. Increased sleep apnea risk was associated with unemployment (OR 1.96, 95% CI 1.11-3.49), high body mass index (OR 1.17, 95% CI 1.11-1.24), snoring (OR 16.7, 95% CI 9.0-31.0), hypertension (OR 4.33, 95% CI 2.28-8.22), arthritis (OR 2.00, 95% CI 1.01-4.01), and other medical comorbidities (OR 2.65, 95% CI 1.24-5.68).
Insomnia and sleep apnea are highly prevalent and likely underdiagnosed in this cohort from Lebanon and are associated with disadvantaged socioeconomic status and medical comorbidities. This alarming prevalence of sleep difficulties and disorders calls for future research exploring the causes including the potential effect of social, economic, and political instability, mental and psychological stress, local customs, and environmental factors.
黎巴嫩人群睡眠障碍的患病率尚不清楚。我们评估了失眠和睡眠呼吸暂停风险的患病率，并在大贝鲁特的一个样本中研究了它们与社会人口统计学、生活方式和健康特征之间的关系。
这项横断面试点调查纳入了501名社区成年人（年龄45.2±15.2岁，64%为女性）。使用睡眠心脏健康研究和柏林问卷评估失眠症状、失眠症和睡眠呼吸暂停风险。比较有无失眠症状、失眠症和睡眠呼吸暂停的个体之间的特征。使用多变量回归评估相关因素。
共有44.5%的参与者报告失眠症状每月超过15晚，34.5%报告患有失眠症。失眠症状和失眠症的预测因素包括女性（优势比[OR]分别为1.51，95%置信区间[CI]为1.01 - 2.27和OR 1.76，95% CI为1.13 - 2.75）、高中以下教育水平（OR分别为1.96，95% CI为1.31 - 2.95和OR 2.40，95% CI为1.52 - 3.77）以及合并症（OR分别为2.27，95% CI为1.30 - 3.95和OR 3.02，95% CI为1.3 - 5.27）。尽管31%的参与者有较高的睡眠呼吸暂停风险，但只有5%的人从医生那里得到了诊断。睡眠呼吸暂停风险增加与失业（OR 1.96，95% CI 1.11 - 3.49）、高体重指数（OR 1.17，95% CI 1.11 - 1.24）、打鼾（OR 16.7，95% CI 9.0 - 31.0）、高血压（OR 4.33，95% CI 2.28 - 8.22）、关节炎（OR 2.00，95% CI 1.01 - 4.01）以及其他合并症（OR 2.65，95% CI 1.24 - 5.68）有关。
在这个来自黎巴嫩的队列中，失眠和睡眠呼吸暂停非常普遍，可能诊断不足，并且与社会经济地位不利和合并症有关。这种令人担忧的睡眠困难和障碍的患病率要求未来进行研究，探索其原因，包括社会、经济和政治不稳定、精神和心理压力、当地习俗以及环境因素的潜在影响。
