Hamdan Al-Jahdali1,2,3, Anwar E Ahmed4,5, Al-Harbi Abdullah6,7, Khan Ayaz6,7, Almuttari Ahmed6,7, ALGamedi Majed6,7, Alyami Sami6,7, Almuhayshir Amirah6,7, Dahman Bassam8. 1. King Saud Bin Abdulaziz University for Health Sciences, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia. jahdalih@gmail.com. 2. King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. jahdalih@gmail.com. 3. Pulmonary Division, King Saud University for Health Sciences, Medical Director of Sleep Disorders Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia. jahdalih@gmail.com. 4. Department of Preventive Medicine and Biostatistics, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA. 5. Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA. 6. King Saud Bin Abdulaziz University for Health Sciences, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia. 7. King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. 8. Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA.
Abstract
BACKGROUND: Research on obstructive sleep apnea (OSA) is inadequate in Saudi Arabia, particularly among patients with comorbidities. This study investigates comorbidities in patients with different severity of apnea based on the Apnea-Hypopnea Index (AHI). METHODS: The retrospective charts review that included a cohort of 4391 patients who underwent polysomnography (PSG) between 2003 and 2019. The AHI is classified into four ordinal groups: normal, mild, moderate, and severe. Ordinal logistic regression was used to model proportional odds of a higher AHI category. RESULTS: Gender was distributed equally in the study sample. The average age was 49.6 ± 14.8 years and the average AHI was 16.1 ± 22 per hour. Hypertension (43.2%) and diabetes mellitus (37.3%) were the most common comorbidities: Mild OSA 28.9%, Moderate OSA 15.6%, and severe 16.4%. The severity of apnea increased with age and BMI classes. The prevalence of hypertension increased with the severity of apnea: 42.9% in mild, 47.4% in moderate, and 54.6% in severe AHI. The prevalence of coronary artery disease (CAD), congestive heart failure (CHF), and diabetes mellitus (DM) increased with the severity of apnea. Comorbidities was more among OSA patients with excessive sleepiness. After adjustment for age and gender, greater proportional odds of severe AHI were observed in males (aOR = 1.8), 30-59 years (aOR = 2.064), 60 years or above (aOR = 2.873), obese class II (aOR = 2.016), obese class III (aOR = 2.527), and in patients with hypertension (aOR = 1.272). CONCLUSION: Hypertension and obesity were highly prevalent in the study cohort and were associated with greater proportional odds of severe AHI.
BACKGROUND: Research on obstructive sleep apnea (OSA) is inadequate in Saudi Arabia, particularly among patients with comorbidities. This study investigates comorbidities in patients with different severity of apnea based on the Apnea-Hypopnea Index (AHI). METHODS: The retrospective charts review that included a cohort of 4391 patients who underwent polysomnography (PSG) between 2003 and 2019. The AHI is classified into four ordinal groups: normal, mild, moderate, and severe. Ordinal logistic regression was used to model proportional odds of a higher AHI category. RESULTS: Gender was distributed equally in the study sample. The average age was 49.6 ± 14.8 years and the average AHI was 16.1 ± 22 per hour. Hypertension (43.2%) and diabetes mellitus (37.3%) were the most common comorbidities: Mild OSA 28.9%, Moderate OSA 15.6%, and severe 16.4%. The severity of apnea increased with age and BMI classes. The prevalence of hypertension increased with the severity of apnea: 42.9% in mild, 47.4% in moderate, and 54.6% in severe AHI. The prevalence of coronary artery disease (CAD), congestive heart failure (CHF), and diabetes mellitus (DM) increased with the severity of apnea. Comorbidities was more among OSA patients with excessive sleepiness. After adjustment for age and gender, greater proportional odds of severe AHI were observed in males (aOR = 1.8), 30-59 years (aOR = 2.064), 60 years or above (aOR = 2.873), obese class II (aOR = 2.016), obese class III (aOR = 2.527), and in patients with hypertension (aOR = 1.272). CONCLUSION: Hypertension and obesity were highly prevalent in the study cohort and were associated with greater proportional odds of severe AHI.
Authors: Ahmed S Bahammam; Mohammed S Al-Rajeh; Fatimah S Al-Ibrahim; Maria A Arafah; Munir M Sharif Journal: Saudi Med J Date: 2009-12 Impact factor: 1.484