Epidemiological characteristics of obstructive sleep apnea in a hospital-based historical cohort in Lebanon

PLoS One. 2020 May 15;15(5):e0231528. doi: 10.1371/journal.pone.0231528. eCollection 2020.

Abstract

The objective of our study was to characterize and analyze the associations between OSA (obstructive sleep apnea) and other clinical variables in adult patients referred for sleep evaluation by polysomnography at a referral center in Beirut, Lebanon, in terms of sociodemographic features, symptoms presentation and comorbidities, and evaluate the burden of comorbidities associated with this disease. All individuals with suspected Sleep Apnea referred (January 2010-September 2017) for a one-night polysomnography were included. Demographics, self-reported symptoms and comorbidities were documented. The relationship between OSA severity and the presence of symptoms and comorbidities were evaluated using multivariate logistic regression. Overall, 663 subjects were assessed. Of these, 57.3% were referred from chest physicians, and sleep test results were abnormal in 589 subjects (88.8%) of whom 526 patients (89.3%) fulfilled diagnostic criteria for OSA; 76.3% were men and women were on average older. OSA was severe in 43.2% and more severe in men. Almost all patients were symptomatic with ~2-4 symptoms per patient and women presented with symptoms that are more atypical. Comorbidities were significantly higher in women. In the multivariate analysis, age, male sex, obesity, symptoms of snoring, excessive daytime somnolence and witnessed apneas were associated with OSA severity. Only age and obesity were associated with self-reported diagnosis of hypertension and diabetes. This is the first study in Lebanon to explore the characteristics of patients with polysomnography-diagnosed OSA. High prevalence of severe OSA and low referral rates in the medical community support promoting awareness for an earlier diagnosis and more personalized approach in this country.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Hypertension / physiopathology*
  • Lebanon / epidemiology
  • Male
  • Medical History Taking
  • Middle Aged
  • Obesity / physiopathology*
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index*
  • Sleep Apnea, Obstructive / diagnosis
  • Sleep Apnea, Obstructive / epidemiology*
  • Snoring / physiopathology*
  • Young Adult

Grants and funding

The research was funded by a grant from Philips. The funding body was not involved in the design or conduct of the study, collection, management, analysis or interpretation of data, preparation or review of the manuscript.