A Community Study of Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) in Middle-Aged Bangladeshi Population

Abstract

PURPOSE: To assess the prevalence as well as clinical and anthropometric predictors of Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) among the middle-aged urban community of Bangladeshi. METHODS: The study was a prospective two-stage, cross-sectional, community-based prevalence study, performed in an Urban Community of Dhanmondi, Dhaka. About 2500 citizens, aged 30-60 years residing in the Dhanmondi, Dhaka were the study population. Person with recent myocardial infarction, upper airway surgery, class iii/iv congestive heart failure, pregnancy, hypothyroidism on treatment, acromegaly, chronic renal failure, systemic steroid treatment and hormone replacement therapy were excluded. Stage 1 of the study consisted of the administration of the sleep questionnaire and brief anthropometric measurements were performed in 2,500 subjects. They were screened by means of a sleep questionnaire, a modified version of the Wisconsin sleep cohort questionnaire which included questions about demographics, sleep symptoms, medical history, and medications. Total 2250 subjects returned the questionnaire. The respondents were divided as per their snoring habits in to habitual snorers and non-habitual snorers. Among them 495 were habitual snorers and 1755 were non-habitual snorers. In stage 2 of the study, 60 habitual snorers and same number of non-habitual snorers were randomly selected for standard overnight PSG. RESULTS: The prevalence of OSAH in habitual snorers was 48.33% (239/495), and that in non-habitual snorers was 1.66% (29/1755). So, the overall prevalence of OSAH in the screened population was 11.91%, and that of OSAHS was 3.29%. Likewise, the prevalence of OSAH and OSAHS in the men was 17.37% and 4.49%, respectively. The prevalence of OSAH and OSAHS in women was 6.25% and 2.14% respectively on extrapolation. Multivariate analysis revealed that male gender, age, obesity (defined by a high body mass index), wait/hip ratio were significant risk factors for OSAHS. CONCLUSIONS: This study demonstrated that the risk factors and prevalence for OSAHS in urban population of Bangladesh are similar to those in the Western studies.