Study of the prevalence of sleep apnea syndrome's symptoms in a Moroccan population
Bir Fas popülasyonunda uyku apne sendromu prevalansı çalışmasıGiriş: Uyku apne sendromu genel popülasyonda gittikçe artan yaygın ve tanısız bir sendrom olup, Fası da içeren bazı po-pülasyonlarda spesifik prevalansıyla ilgili çalışma bulunmamaktadır.Materyal ve Metod: Bu çalışmanın amacı; 21-66 yaş aralığında, 288i erkek ve 215i kadından oluşan orta yaşlı bir Fas po-pülasyonunda epidemiyolojik araştırma ile horlama, tanıklı apne ve aşırı gündüz uykululuğu içeren uyku apne sendro-munun temel klinik semptomların prevalansını iki anket ile belirlemektir: uykuyu değerlendirmek için Berlin anketi vegündüz uykululuğunu değerlendirmek için Epworth skalası. Bulgular: Ortalama yaş 42.7 ± 14.3 yıldı. Epworth uykululuk skalası skoru ortalama 6.9 ± 3.4 (1-16) olarak bulundu veaşırı gündüz uykululuğu olanların %21.7sinde 10un üzerindeydi. Horlama ve apnenin genel popülasyonda prevalansı sı-rasıyla %54.7 ve %11.1, erkeklerde %63.9 ve %13.9, kadınlarda %42.3 ve %7.4tü. On üçü kadın, 35i erkek toplam 48 (%9.5)kişide uyku apne sendromunu düşündüren bu üç temel klinik bulgu mevcuttu. Bu subgrup genel popülasyona göre da-ha yaşlı (p= 0.04) ve daha kiloluydu (p= 0.03). Hipertansiyon varlığı bu subgrupta anlamlı olarak yüksek değildi.Sonuç: Çalışmamızda, uyku apne sendromunun temel semptomlarının prevalansı yüksekti (%9.5). Tanının konulması veFas popülasyonunda kesin prevalansın belirlenmesi için poligrafi veya polisomnografi gereklidir.
Bir Fas popülasyonunda uyku apne sendromu prevalansı çalışması
Introduction: Sleep apnea syndrome is increasingly common in the general population and is under-diagnosed but we lackstudies on the estimation of its specific prevalence in several populations including Morocco.Materials and Methods: The aim of the study is to determine the prevalence of the main clinical symptoms of sleep apneasyndrome including snoring, witnessed apnea and excessive daytime sleepiness in a middle aged Moroccan populationthrough an epidemiological investigation in 288 men and 215 women, aged between 21 to 66 years who completed twoself-questionnaires: the Berlin questionnaire to assess sleep and the Epworth scale to assess daytime sleepiness.Results:The mean age was 42.7 years ± 14.3. The Epworth Sleepiness Scale was on average 6.9 ± 3.4 (range: 1-16). It wasabove 10 in 21.7% in favor of excessive daytime sleepiness. The prevalence of snoring and apnea was respectively 54.7%and 11.1% in the general population, 63.9% and 13.9% in men, 42.3% and 7.4% in women. Forty eight subjects (9.5%) inc-luding 13 women and 35 men had the combination of these three main clinical signs suggestive of sleep apnea syndrome.This subpopulation was older (p= 0.04) and with more overweight (p= 0.03) than the general population. Hypertension ra-te was not statistically higher in this subgroup.Conclusion: Prevalence of the main symptoms of sleep apnea syndrome is high in our study (9.5%). Polygraphy or poly-somnography is warranted to diagnose and have an exact prevalence in the Moroccan population.
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- 1.Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993; 328: 1230-5.
- 2.Nieto FJ, Young TB, Lind BK, Shahar E, Samet JM, Redline S, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study: Sleep Heart Health Study. JAMA 2000; 283: 1829-36.
- 3.Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 2000; 342: 1378-84.
- 4.Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 2005; 353: 2034-41.
- 5.McArdle N, Riha RL, Vennelle M, Coleman EL, Dennis MS, Warlow CP, et al. Sleep-disordered breathing as a risk factor for cerebrovascular disease: a case-control study in patients with transient ischemic attacks. Stroke 2003; 34: 2916-21.
- 6.Peker Y, Carlson J, Hedner J. Increased incidence of coronary artery disease in sleep apnoea: a long-term follow-up. Eur Res- pir J 2006; 28: 596-602.
- 7.Mooe T, Franklin KA, Holmstrom K, Rabben T, Wiklund U. Sle- ep disordered breathing and coronary artery disease: long- term prognosis. Am J Respir Crit Care Med 2001; 164: 1910-3.
- 8.Logan AG, Perlikowski SM, Mente A, Tisler A, Tkacova R, Ni- roumand M, Leung RS, Bradley TD. High prevalence of unre- cognized sleep apnoea in drug-resistant hypertension. J Hypertens 2001; 19: 2271-7.
- 9.Lavie P, Herer P, Hoffstein V. Obstructive sleep apnea syndro- me as a risk factor for hypertension: population study. BMJ 2000; 320: 479-82.
- 10.Punjabi NM, Shahar E, Redline S, Gottlieb DJ, Givelber R, Res- nick HE; Sleep Heart Health Study Investigators. Sleep-disorde- red breathing, glucose intolerance, and insulin resistance: the Sleep Heart Health Study. Am J Epidemiol 2004; 160: 521-30.
- 11.Reichmuth KJ, Austin D, Skatrud JB, Young T. Association of sleep apnea and type II diabetes: a population-based study. Am J Respir Crit Care Med 2005; 172: 1590-5.
- 12.Coughlin SR, Mawdsley L, Mugarza JA, Calverley PM, Wil- ding JP. Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. Eur He- art J 2004; 25: 735-41.
- 13.Prévalence des symptômes du syndrome dapnées du somme- il. Étude dans une population française dâge moyen. N. Mes- lier1, S. Vol2, B. Balkau3, F. Gagnadoux1, M. Cailleau2, A. Pet- rella2, J.L. Racineux1, J. Tichet2, et le groupe détude DESIR. Rev Mal Respir 2007; 24: 305-13.
- 14.Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructi- ve sleep apnea: a population health perspective. Am J Respir Crit Care Med 2002; 165: 1217-39.
- 15.Strohl KP, Redline S. Recognition of obstructive sleep apnea. Am J Respir Crit Care Med 1996; 154: 279-89.
- 16.Vgontzas AN, Papanicolaou DA, Bixler Eo, Hopper K, Lotsikas A, lin HM, et al. Sleep apnea and daytime sleepiness and fati- gue: relation to visceral obesity, insulin resistance, and hypercytokinemia. J Clin Endocrinol Metab 2000; 85: 1151-8.
- 17.Millman RP, Carlisle CC, McGarvey ST, Eveloff SE, Levinson PD. Body fat distribution and sleep apnea severity in women. Chest 1995; 107: 362-6.
- 18.Dancey DR, Hanly PJ, Soong C, Lee B, Shepard J Jr, Hoffste- in V. Gender differences in sleep apnea: the role of neck cir- cumference. Chest 2003; 123: 1544-50.
- 19.Ancoli-Israel S, Kripke D, Klauber M, Mason W, Fell R, Kaplan O. Sleep-disordered breathing in community-dwelling elderly. Sleep 1991; 14: 486-95.
- 20.Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructi- ve sleep apnea: a population health perspective. Am J Respir Crit Care Med 2002; 165: 1217-39.
- 21.Young T, Peppard PE, Taheri S. Excess weight and sleep-disor- dered breathing. J Appl Physiol 2005; 99: 1592-9.
- 22.Weitzenblum E, Chaouat A, Kessler R, Krieger J. Syndrome dapnées obstructives du sommeil. Encyclopédie Médico-Chi- rurgicale 6-040-K-05, 2000; 13p.
- 23.Peppard PE, Young T, Palta M, Dempsey J, Skatrud J. Longi- tudinal study of moderate weight change and sleep-disorde- red breathing. JAMA 2000; 284: 3015-21.
- 24.OKeeffe T, Patterson EJ. Evidence supporting routine poly- somnography before bariatric surgery. Obes Surg 2004; 14: 23-6.
- 25.van Kralingen KW, de Kanter W, de Groot GH, Venmans BJ, van Boxem T, van Keimpema AR, Postmus PE. Assessment of sleep complaints and sleep-disordered breathing in a consecu- tive series of obese patients. Respiration 1999; 66: 312-6.
- 26.Rajala R, Partinen M, Sane T, Pelkonen R, Huikuri K, Seppala- inen AM. Obstructive sleep apnoea syndrome in morbidly obese patients. J Intern Med 1991; 230: 125-9.
- 27.Akashiba T, Kawahara S, Akahoshi T, Omori C, Saito O, Ma- jima T, et al. Relationship between quality of life and mood or depression in patients with severe obstructive sleep apnea syndrome. Chest 2002; 122: 861-5.
- 28.Engleman HM, Douglas NJ. Sleep. 4. Sleepiness, cognitive function, and quality of life in obstructive sleep apno- ea/hypopnoea syndrome. Thorax 2004; 59: 618-22.
- 29.Jenkinson C, Stradling J, Petersen S. Comparison of three me- asures of quality of life outcome in the evaluation of continu- ous positive airway pressure therapy for sleep apnoea. J Sle- ep Res 1997; 6: 199-204.
- 30.Roisman G, Ibrahima Escourroua P. Pourquoi et comment di- agnostiquer les troubles respiratoires du sommeil? Revue de Pneumologie Clinique 2009; 65: 203-13.
- 31.Johns MW. A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 1991; 14: 540-5.
- 32.Deegan PC, McNicholas WT. Predictive value of clinical featu- res for the obstructive sleep apnoea syndrome. Eur Respir J 1996; 9: 117-24.