非洲一般人群睡眠呼吸障碍的患病率：贝宁学会和睡眠（BeSAS）研究。

Prevalence of sleep-disordered breathing in an African general population: The Benin Society and Sleep (BeSAS) study.

机构信息

Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin; Laboratory of Epidemiology of Chronic and Neurological Diseases, Cotonou, Benin; National Teaching Hospital for Tuberculosis and Pulmonary Diseases, Cotonou, Benin.

Laboratory of Epidemiology of Chronic and Neurological Diseases, Cotonou, Benin; National School of Public Health, University of Parakou, Parakou, Benin.

出版信息

Lancet Respir Med. 2022 Sep;10(9):831-839. doi: 10.1016/S2213-2600(22)00046-7. Epub 2022 Apr 8.

DOI:10.1016/S2213-2600(22)00046-7

PMID:35405141

Abstract

BACKGROUND

Data on the prevalence of sleep-disordered breathing (SDB) in the African general population are scarce, and a better understanding is urgently needed. Our study aimed to objectively determine the prevalence of, and factors associated with, SDB in a large sample in Benin, west Africa.

METHODS

In the Benin Society and Sleep (BeSAS) cross-sectional study, participants aged 25 years and older were recruited from both urban and rural areas. Rural participants were recruited from Tanve, a village located 200 km north of Cotonou, and urban participants were recruited from Cotonou. The participants underwent respiratory polygraphy at home using a type-3 device that measures airflow through a nasal pressure sensor, respiratory effort (thoracic movement), and pulse oximetry. Clinical and morphometric data were also collected. SDB severity categories were defined according to the apnoea-hypopnoea index (AHI), with mild-to-severe SDB (AHI ≥5/h), moderate-to-severe SDB (AHI ≥15/h), and severe SDB (AHI ≥30/h).

FINDINGS

The study was completed from April 4, 2018 to Jan 15, 2021. Of 2909 participants recruited in the BeSAS study, 2168 (74·5%) underwent respiratory polygraphy. For the 1810 participants with complete polygraphic data (mean age 46 years, SD 15; 1163 [64·2%] women), the prevalence of mild-to-severe SDB (AHI ≥5/h) was 43·2% (95% CI 40·9-45·5), of moderate-to-severe SDB (AHI ≥15/h) was 11·6% (10·2-13·1), and of severe SDB (AHI ≥30/h) was 2·7% (2·0-3·5). Factors independently associated with SDB were advanced age, male sex, large neck circumference, abdominal obesity, overweight or obesity, and snoring. After multivariable adjustment, severe SDB was independently associated with hypertension in women (odds ratio 3·99, 95% CI 1·04-15·33; p=0·044), but not in men (odds ratio 0·67, 0·22-2·05; P=0·63).

INTERPRETATION

The BeSAS study provides the first large-scale objective evaluation of SDB prevalence and associated factors in Africa. The high prevalence of SDB identified should stimulate the development of public health policies to prevent and treat this condition in African countries.

FUNDING

Ligue Pulmonaire Vaudoise, Switzerland.

摘要

背景

关于非洲普通人群睡眠呼吸障碍（SDB）的流行情况的数据很少，因此迫切需要更好地了解。我们的研究旨在客观地确定在西非的一个大样本中 SDB 的流行程度和相关因素。

方法

在贝宁社会与睡眠（BeSAS）的横断面研究中，招募了年龄在 25 岁及以上的来自城市和农村地区的参与者。农村地区的参与者是从位于科托努以北 200 公里的坦韦村招募的，而城市地区的参与者则是从科托努招募的。参与者在家中使用测量通过鼻压传感器的气流、呼吸努力（胸部运动）和脉搏血氧饱和度的 3 型设备进行呼吸描记法。还收集了临床和形态计量学数据。SDB 严重程度类别根据呼吸暂停低通气指数（AHI）定义，轻度至重度 SDB（AHI≥5/h）、中度至重度 SDB（AHI≥15/h）和重度 SDB（AHI≥30/h）。

结果

该研究于 2018 年 4 月 4 日至 2021 年 1 月 15 日完成。在 BeSAS 研究中招募的 2909 名参与者中，有 2168 名（74.5%）接受了呼吸描记法。在 1810 名具有完整描记数据的参与者（平均年龄 46 岁，标准差 15；1163[64.2%]名女性）中，轻度至重度 SDB（AHI≥5/h）的患病率为 43.2%（95%CI 40.9-45.5），中度至重度 SDB（AHI≥15/h）的患病率为 11.6%（10.2-13.1），重度 SDB（AHI≥30/h）的患病率为 2.7%（2.0-3.5）。与 SDB 相关的独立因素是年龄较大、男性、较大的颈围、腹部肥胖、超重或肥胖以及打鼾。多变量调整后，严重 SDB 与女性的高血压独立相关（比值比 3.99，95%CI 1.04-15.33；p=0.044），但与男性无关（比值比 0.67，0.22-2.05；P=0.63）。