Prevalence Of Obstructive Sleep Apnea-hypopnea Syndrome In Chinese Adults In Guangzhou

Obstructive sleep apnea-hypopnea syndrome (OSAHS), the most common type of sleep-disordered breathing (SDB) in adults, is associated with excessive daytime sleepiness (EDS) and coronary and cerebrovascular diseases even impairs other systems. Currently, the epidemiologic study of OSAHS in our country is so limited that the related survey could only be found in Shanghai, Chengde, Taiyuan, Fuzhou. It would be a waste of time and costly if all of the subjects were invited to undergo polysomnography (PSG) which is the golden criterion for the diagnosis of OSAHS. In this study, the comparison of the clinical usage between portable monitors (PM) and PSG will be showed at first, so that the group with related symptoms could use PM for diagnosis, and the prevalence of OSAHS in Guangzhou will be estimated to provide evidence for the strategy of treatment and prevention.PartⅠComparison of the clinical usage between unattended portable monitors and polysomnographyObjectiveTo offer recommendations of the clinical application of PM by comparison between PM and PSG in diagnosis of OSAHS. MethodsPatients who snored at night with or without sleep apnea were enrolled and their history were collected to find if they had EDS or other problems during sleep. All of them underwent PSG in-lab primarily and were monitored by PM at home with the understanding of the usage showing by a technician. The results were analyzed to compare the difference of each parameter between the two methods as well as the accuracy of PM was evaluated.Results1. 50 patients (46 men and 4 women) were recruited, the mean age was 44.86±11.22 years old, and there were 30 patients in the age group of 35-60 years old, the mean BMI were 26.64±3.17 kg/m2.2. There was no significant difference in apnea-hypopnea index (AHI), saturation impair time index (SIT),the minimal SaO2,and the mean SaO2 between the two diagnostic methods (P > 0.05). Sensitivity and specificity of PM were 97.62% and 75%, LR+=3.9048, LR-=0.0317, PV+=0.1078, PV-=0.9990.3. The agreement in AHI measurement between PM and PSG was evaluated according to the Bland and Altman method. ConclusionsSleep data did not differ between the first and second nights, whatever the method used. As it has highly sensitivity but not enough specificity, PM is appropriate to be the primarily screen for those with high risk for OSAHS.PartⅡPrevalence of obstructive sleep apnea-hypopnea syndrome in Chinese adults in GuangzhouObjectiveThe study was performed to assess the prevalence of obstructive sleep apnea-hypopnea syndrome in Guangzhou to provide the data for a increasingly recognize of this disease and making strategies for treatment and prevention of this disorder.MethodsSleep questionnaires were distributed to 7684 people living in Guangzhou from 8 districts which were based on a random sample. All of the subjects were briefed about our study in a face-to-face interview and the moderate and severe snorer with ESS scores≥9 were invited to undergo all-night PM. The prevalence of OSAHS was conservatively estimated according to AHI and ESS.Results6712 subjects participated the study, among them 5620 (83.73%) were available for evaluation. There were 363 (6.46%) subjects with ESS scores≥9 and 90 of them were moderate and severe snorers simultaneously. 73 subjects agreed to undergo PM. The patients with ESS scores≥9 were clustered in the age-group of≤30 and 40-49 years old, the ESS scores were higher in males than in females whereas the number showed opposite result. Smoking, drinking, were associated with the severity of EDS. The cognition of OSAHS was still limited. The conservatively estimated prevalence of OSAHS was 1.45% when AHI≥5 and ESS scores≥9 were taken as the diagnosis criteria.ConclusionsThe prevalence of OSAHS in Guangzhou in adults was 1.45%. The cognition of OSAHS was so limited that the harmful of this disease should be disseminated to attach much more attention to it.