Comorbidities and quality of life in Australian men and women with diagnosed and undiagnosed high-risk obstructive sleep apnea

Sowmya Krishnan; Ching Li Chai-Coetzer; Nicole Grivell; Nicole Lovato; Sutapa Mukherjee; Andrew Vakulin; Robert J Adams; Sarah L Appleton

doi:10.5664/jcsm.9972

Comorbidities and quality of life in Australian men and women with diagnosed and undiagnosed high-risk obstructive sleep apnea

J Clin Sleep Med. 2022 Jul 1;18(7):1757-1767. doi: 10.5664/jcsm.9972.

Authors

Sowmya Krishnan¹, Ching Li Chai-Coetzer^{1

2}, Nicole Grivell², Nicole Lovato², Sutapa Mukherjee^{1

2}, Andrew Vakulin², Robert J Adams^{1

2}, Sarah L Appleton²

Affiliations

¹ Respiratory and Sleep Services, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia.
² Flinders Health and Medical Research Institute-Sleep Health (Adelaide Institute for Sleep Health), College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.

Abstract

Study objectives: In a population-based survey, we determined sex differences in health profiles and quality of life between individuals who have a confirmed diagnosis of obstructive sleep apnea (OSA) and those who are at high risk of OSA yet remain undiagnosed.

Methods: An online survey of Australian adults ≥ 18 years (n = 3,818) identified participants with self-reported diagnosed OSA (n = 460) or high-risk, undiagnosed OSA (OSA50 score ≥ 5, n = 1,015). Ever-diagnosed comorbidities, sociodemographics, and quality of life (EQ-5D-5L, Functional Outcomes of Sleep Questionnaire-10) were assessed.

Results: Women were more frequently represented in the high-OSA-risk group compared with those with diagnosed OSA (55.5%, n = 563, versus 43%, n = 198; P < .001). In sex-specific logistic regression analyses, diagnosed OSA was associated with increased likelihoods of ≥ 1 cardiovascular condition (odds ratio: 3.0; 95% confidence interval: 2.0-4.5), hypertension (1.9; 1.3-2.8), gout (1.8; 1.1-2.9), and chronic obstructive pulmonary disease (3.8; 2.1-6.9) in men. In women, an association with asthma (2.0; 1.3-3.0) was seen. Diabetes, arthritis, mental health conditions (ever-diagnosed), and all EQ-5D-5L dimensions were associated with an OSA diagnosis regardless of sex, except for EQ-5D-5L anxiety/depression, which was only associated with an OSA diagnosis in women. A diagnosis of OSA was associated with sleepiness-related impairment (lowest quartile of Functional Outcomes of Sleep Questionnaire-10) in men (1.6; 1.01-2.5) and women (2.2; 1.4-3.6).

Conclusions: Sex-specific health conditions may drive diagnosis of OSA; however, clinical suspicion of OSA needs to be increased in men and women. The impaired quality of life and persistent sleepiness in participants with diagnosed OSA observed at a population level requires greater clinical attention.

Citation: Krishnan S, Chai-Coetzer CL, Grivell N, et al. Comorbidities and quality of life in Australian men and women with diagnosed and undiagnosed high-risk obstructive sleep apnea. J Clin Sleep Med. 2022;18(7):1757-1767.

Keywords: OSA50; comorbidities; diagnosis; epidemiology; obstructive sleep apnea; sex.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Australia / epidemiology
Comorbidity
Female
Humans
Male
Quality of Life* / psychology
Sleep Apnea, Obstructive* / diagnosis
Sleep Apnea, Obstructive* / epidemiology
Sleep Apnea, Obstructive* / psychology
Sleepiness