The prevalence of high risk obstructive sleep apnoea among patients with type 2 diabetes in Jordan

Obstructive sleep apnea risk and determinant factors among type 2 diabetes mellitus patients at the chronic illness clinic of the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

Introduction

Obstructive sleep apnea is a sleep complaint among type 2 diabetes mellitus patients that has a deleterious effect on health with immediate and long-term impacts. Despite its impacts, data on the magnitude and predictors of obstructive sleep apnea among type 2 diabetes mellitus patients in Ethiopia is still limited. Thus, this study was conducted to determine how common a high risk of obstructive sleep apnea is and its predictors among type 2 diabetes mellitus patients receiving follow-up care at the chronic illness follow-up clinic at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2022.

Methods

An institution-based cross-sectional study was conducted. Interviewer-administered questionnaires and physical measurements with standard instruments were used to collect the required data. The collected data were entered into EpiData 4.6 and exported into STATA 14. Both Bivariable and multivariable binary logistic regression analyses were done to identify factors associated with a high risk of obstructive sleep apnea. Variables with a p-value ≤0.05 in the multivariable logistic regression analysis were declared as significantly associated with a high risk of obstructive sleep apnea.

Results

A total of 319 type 2 diabetes mellitus patients with a median age of 58 years participated in our current study. The overall prevalence of a high risk of obstructive sleep apnea among the study participants was 31.97% (95%CI: 27.06, 37.32). On multivariable logistic analysis, a neck circumference of ≥40 cm (AOR=4.33, 95%CI 1.37, 13.72), physical inactivity (AOR=2.29, 95%CI 1.15, 4.53), comorbid hypertension (AOR=4.52, 95%CI 2.30, 9.18), and male sex (AOR=8.01, 95%CI 3.02, 21.24) were associated with a high risk of obstructive sleep apnea.

Conclusion and recommendation

The prevalence of a high risk of obstructive sleep apnea among type 2 diabetes mellitus patients remains high. A neck circumference of ≥40 cm, physical inactivity, comorbid hypertension, and male sex were significantly associated with a high risk of obstructive sleep apnea among type 2 diabetes mellitus patients. Screening and evaluation of type 2 diabetes mellitus patients for obstructive sleep apnea are recommended to avoid the negative impacts.

Obstructive sleep apnea risk and its associated factors among type 2 diabetes mellitus patients at wolkite university specialized hospital, Wolkite, Southern Ethiopia, 2021. A comparative cross-sectional study

BACKGROUND

Obstructive sleep apnea is a syndrome characterized by recurrent partial, or complete upper airway collapse during sleep. Although obstructive sleep apnea is common in type 2 diabetes mellitus, the majority of patients remain undiagnosed because of the prohibitive cost of the test and paucity of the sleep clinic, especially in developing nations. The study aimed to assess high-risk obstructive sleep apnea and its associated factors among type 2 diabetes mellitus patients at Wolkite University Specialized Hospital.

METHODS

A Hospital-based comparative cross-sectional study was employed from October 15 to December 5, 2021, among 204 participants. Data collection was done by semi-structured interviewer-administered questionnaires. Data was entered into the Epi data version 4.6 and exported to SPSS version 25.0 for analysis. Independent t-test and chi-square test were used to compare continuous and categorical variables accordingly. Binary and multiple logistic regression analysis was used to assess factors associated with high-risk obstructive sleep apnea. Statistical significance was set at P-value < 0.05.

RESULTS

A total of 204 participants with an equal proportion of the two groups were included with a 100% response rate. About 56.9% of the participants were males. The mean age of type 2 diabetes mellitus patients was 57.1 (± 12.0) years and the non-diabetic group was 55.3 (± 10.9) years. The prevalence of high-risk obstructive sleep apnea among type 2 diabetes mellitus was 42.2%, and that of non-diabetics was 13.7% (p < 0.001). Age (AOR: 1.13; 95%CI: 1.04, 1.22), neck grasp (AOR: 6.48; 95%CI: 1.56, 26.96), waist circumference (AOR: 4.44; 95%CI: 1.12, 17.61) and the presence of diabetes-related complications (AOR: 4.18; 95%CI: 1.13, 15.43) were independently associated with high-risk obstructive sleep apnea among type 2 diabetes mellitus patients.

CONCLUSION

The prevalence of high-risk obstructive sleep apnea among type 2 diabetes mellitus was higher with a significant difference from their comparison group. Age, neck grasp, waist circumference, and diabetes-related complications were significantly associated with high-risk obstructive sleep apnea among type 2 diabetes mellitus patients. Therefore, type 2 diabetes mellitus patients should be screened for obstructive sleep apnea in the early course of their follow-up to take preventive measures and early treatments.

Assessment of the risk of obstructive sleep apnoea among patients with type 2 diabetes and its associated factors using the STOP-BANG questionnaire: A cross-sectional study

Objective

To assess the risk of obstructive sleep apnoea (OSA) and its associated risk factors among patients with type 2 diabetes in southern KSA.

Methods

This was a cross-sectional study conducted at the Armed Forces Hospital in Jazan. The prevalence of OSA was assessed using a validated Arabic translation of the STOP-BANG screening questionnaire. The odds of a higher OSA risk were calculated via regression analysis, according to the measured clinical and demographic variables.

Results

The total number of participants was 306, of which 213 (69.6%) were over the age of 50, 247 (80.7%) were married, and 161 (52.6%) were female. The overall median score of the OSA risk level assessed by the STOP-BANG items was three on a scale of 0–8, of which 193 (63.1%) of the participants in the sample were classified as being at high risk of developing OSA. Several statistically significant associations were identified, where odds ratios (ORs) with a higher OSA risk level were detected according to age, sex, marital status, waist and neck circumference, haemoglobin A1c (HbA1c) and body mass index levels, duration of diabetes, and comorbidity with hypertension (p < 0.05).

Conclusion

The higher risk of OSA identified in our sample of diabetic patients can be related to a high prevalence of obesity, larger neck circumferences, hypertension, and other factors linked to the duration and treatment of diabetes. Additionally, the association between waist circumference, HbA1c, and duration since the diagnosis of diabetes suggests an interaction effect that requires further investigation.

Analysis of Circulating Microvesicles Levels and Effects of Associated Factors in Elderly Patients With Obstructive Sleep Apnea

Background: The incidence of obstructive sleep apnea (OSA) in the elderly is high, and the disorder is associated with a variety of chronic diseases. Microvesicles (MVs) are extracellular vesicles secreted by various cells during stimulation or apoptosis that play an important role in the pathogenesis of OSA. However, concentrations of circulating MVs in elderly patients with OSA remain unclear.

Methods: Patients aged >60 years old were recruited and underwent polysomnography. Circulating plasma MV concentrations, including annexin V⁺MVs, endothelial MVs (EMVs), platelet MVs (PMVs), and leukocyte MVs (LMVs) levels, were measured using a flow cytometer with different labeling methods. Potential factors affecting the concentration of circulating MVs in elderly patients with OSA were determined via Spearman's correlation and multiple linear regression analysis.

Results: Levels of circulating MVs, including both single- (annexin V⁺MVs, CD144⁺EMVs, CD41a⁺PMVs, and CD45⁺LMVs) and dual-labeled MVs (annexin V⁺CD144⁺EMVs), were elevated in elderly patients with OSA. Circulating MVs were positively correlated with OSA severity (AHI, ODI, and SPO_2min). To some extent, obesity affected the MV concentrations in elderly patients with OSA. In addition, age and comorbidities may be associated with MV levels, but the correlations between the MV levels and age or comorbidities were not significant.

Conclusion: Concentrations of circulating MVs in elderly patients with OSA are associated with the labeling method used, OSA severity, and obesity. The effects of age and comorbidities on circulating MV levels require further verification using a larger sample size.

Prevalence of obstructive sleep apnea risk and associated factors among patients with type 2 diabetes mellitus on follow up at Jimma Medical Center, Southwest Ethiopia

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Obstructive sleep apnea is a periodic, partial or complete obstruction in the upper airway during sleep.

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It is highly prevalent among obese patients with type two diabetes mellitus.

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There were high numbers of participants with high risk of OSA among the study participants.

Background

Obstructive sleep apnea (OSA) is a periodic, partial or complete obstruction in the upper airway during sleep that disrupts normal sleep pattern. Despite its significant morbidities and mortality, the majority of patients with OSA remain undiagnosed. The purpose of this study was to assess the prevalence and associated factors of OSA risk among type 2 diabetes patients on follow up at Jimma Medical Center from January 13 to March 2, 2020.

Method

A hospital based cross-sectional study was conducted and consecutive sampling technique was employed. The stop bang questionnaire was used to assess OSA risk. Data were collected using structured questionnaire and entered into EPI data 3.1 and exported to SPSS version 20 for analysis. Logistic regression was employed to identify factors associated with high risk OSA. A variable having a p-value of <0.2 in the bivariate model was subjected to multivariate analysis. Adjusted odds ratios were calculated at 95% confidence interval and considered significant with a p-value of ≤0.05.

Result

253 patients seen in the outpatient clinic were involved with mean age and mean duration of diabetes was 50.27 ± 14.08 and 6.48 ± 5.20 years respectively. The study finding showed that the prevalence of high risk OSA was 45.5%. According to multivariate analysis comorbid hypertension (AOR = 2; 95% CI: 1.04, 3.89), physical inactivity (AOR = 2.11; 95% CI: 1.11,4), BMI ≥ 30 kg/m²: (AOR = 5.41; 95% CI: 1.68,17.3 and neck circumference > 40 cm: (AOR = 6.3; 95% CI: 2.8,14.2 were independently associated with an increased risk of OSA.

Conclusion

There is high number of participants with high risk of OSA. BMI of ≥ 30 kg/m², physical inactivity, neck circumference of > 40 cm and comorbid hypertension were associated with high risk OSA among participants. Early detection and appropriate interventions are important among high risk groups.

Prevalence of obstructive sleep apnea in patients with type 2 diabetes: A systematic review and meta-analysis

Obstructive sleep apnea (OSA) is highly prevalent among patients with diabetes, intensifying the complications of the disease. Various studies in Iran have reported different prevalence rates. This systematic review and meta-analysis was performed to determine OSA prevalence in patients with type 2 diabetes in Iran. In this study, we evaluated five articles published in Persian and English. The articles were searched using the keywords of obstructive sleep apnea, sleep disordered breathing, sleep apnea, OSA, diabetes mellitus and Iran and all possible combinations of these terms in national databases of Scientific Information Database (SID) and Magiran and international databases of Google Scholar, Web of Science, PubMed and Scopus with no time limit. Data were analyzed using the meta-analysis and random effects model. In addition, the heterogeneity between studies was assessed using I² statistic, and data analysis was performed in Stata version 11. In this study, five articles with a total sample size of 2360 were evaluated. According to the results, the prevalence of OSA in diabetic patients was reported to be 54.50% (95% Confidence Interval [CI]: 39.90-69.09). In addition, the results were indicative of a lower prevalence of OSA in men (63.26%; 95% CI: 43.26-83.26), compared to women (66.22%; 95% CI: 57.60-74.84). According to the results of the study, there was a high OSA prevalence in patients with type 2 diabetes. Therefore, it is crucial to recognize diabetic patients at risk of OSA to decrease the adverse effects of this condition.