Obstructive sleep apnea syndrome: how are we in Portugal?

Rodrigues, Ana Paula; Pinto, Paula; Nunes, Baltazar; Bárbara, Cristina

http://hdl.handle.net/10400.18/3455

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Abstract(s)

Introduction: Obstructive sleep apnea (OSA) is a breathing disorder with serious socio-economic consequences, being currently considered a public health problem, with patients at increased risk of cardiovascular diseases and traffic accidents. Despite the high prevalence of OSA reported in the literature is unknown the magnitude of OSA in Portugal, in particular, the number of cases currently diagnosed. Objectives: 1 To estimate the prevalence of OSA in the population of sentinel general practitioners (GP); 2 To identify factors potentially associated with severe OSA; 3. Characterize the diagnosis and treatment of OSA. Methods: Cross-sectional observational study in which sentinel physicians were invited to participate, by reporting all cases with a diagnosis of OSA (ICPC2 P16) registered on their lists of users. The scientific protocol and questionnaires were sent to physicians who agreed to participate. Results: A sample of 29 sentinel GP participated, with a population under observation of 46.685 users. 311 patients were identified with OSA (76.2% male) with a mean age of 62.8 years. No statistically significant differences between genders were observed. In the population under observation, the prevalence of OSA was 0.67% (CI 95%), being higher in males (1.07%). In the population aged above 25 years, there was a higher prevalence of OSA in both genders (0.89%), emphasizing the differences between genders (1.47% in males and 0.39 in female). The highest prevalence was observed in the age group 65 to 74 years (2.35%), being higher in males (4.02%). Underwent sleep study 97.7% of patients, which 56.2% performed polysomnography, the latter has been largely carried out in public institutions (89.1%). The average waiting time in public institutions was 6.8 months (0-36 months), compared to 1 month in private institutions (0-9 months). According to the severity of OSA, almost half of the patients (48.4%) with information on the apnea hypopnea index or respiratory disturbance index had severe OSA. Obesity (74.2%), hypertension (75.9%) and diabetes mellitus (34.1%) were the most frequent co-morbidities in these patients, verifying that being male (OR: 2.6) and having obesity (OR = 4.0) was associated with an increased risk of having severe OSA for all ages. 89.6% of patients were being treated with nasal CPAP, of which 96.1% had severe OSA and 85.2% had mild-moderate OSA, with a statistically significant difference. Among patients on CPAP, 62.8% were followed in specialized sleep consultation, and only 26.7% of patients who were not under CPAP were being followed in sleep consultation. Conclusion: In this population, the prevalence of OSA was similar to that reported in the literature in older age groups. Male gender and obesity were associated with an increased risk of severe OSA in all ages.

Keywords

Rede Médicos-Sentinela Obstructive Sleep Apnea Estados de Saúde e Doença Síndrome da Apneia Obstrutiva do Sono Prevalence European Respiratory Society