Risk Factors for Obstructive Sleep Apnea and the Association of Obstructive Sleep Apnea with Daytime Sleepiness, Obesity and Comorbidity

Abstract

Objective: The purpose of the study was to identify the factors that affect Obstructive Sleep Apnea Syndrome (OSAS) in adults and determine the association between obstructive sleep apnea and daytime sleepiness, obesity and comorbidity. Materials and Methods: This retrospective study was conducted in Canakkale from July 2017-June 2018 with 682 adults (>= 18 yr). An Apnea-hypopnea index (AHI) score >= 5 obtained from polysomnography measurement was considered as OSAS. The Epworth Sleepiness Scale (ESS) was used to identify excessive daytime sleepiness (EDS). Results: A total of 22.1% of adults had mild, 15.8% moderate and 36.5% severe OSAS. According to multivariate logistic regression analysis, high OSAS risk was associated with men of age greater than 50 years, who were alcohol users, EDS, overweight or obese and had at least two comorbidities (p<0.05). OSAS risk was higher in patients with hypertension and chronic obstructive pulmonary disease (COPD) (p<0.05). According to adjusted multivariate linear regression analysis, with each 1-unit increase in ESS score [beta: 0.416, 95% confidence interval (CI): 0.124, 0.708], Body Mass index (BMI) (beta: 1.701, 95% CI: 1.390, 2.011) and comorbidity (beta: 2.441, 95% CI: 0.121, 4.762), AHI increased significantly. Conclusion: Approximately three out of every four participants had OSAS. Male gender, advanced age, alcohol use, EDS, obesity and the presence of comorbidities increased the risk of OSAS. The risk was higher with hypertension or COPD. AHI increased as the ESS score, BMI and number of comorbidities increased. Healthcare professionals should identify those at risk when detecting undiagnosed OSAS cases and refer them to appropriate clinics for early diagnosis and intervention.