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Simpamba K, May JL, Waghat A, Attarian H, Mateyo K. Obstructive sleep apnea and excessive daytime sleepiness among commercial motor vehicle drivers in Lusaka, Zambia. J Clin Sleep Med 2023; 19:1191-1198. [PMID: 36856062 PMCID: PMC10315601 DOI: 10.5664/jcsm.10538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/02/2023]
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) is a risk factor for a major public health problem, car crashes, due to excessive daytime sleepiness (EDS). Commercial vehicle driving (CVD) is a hazardous occupation, having a high fatality rate worldwide. There have been no studies on EDS and OSA in Zambia despite the high rate of annual road traffic accidents (RTAs). We aim to determine the prevalence of EDS and OSA risk among CVDs in Lusaka, Zambia, to assess the impact of OSA on high RTA rates. METHODS This was a cross-sectional study. The STOP BANG questionnaire and the Epworth Sleepiness Scale were used. Consecutive sampling of drivers was done who were divided into low and high risk of OSA (HROSA). The risk factors associated with OSA in the bivariate analyses were subjected to a multivariate logistic regression model. RESULTS One hundred thirty-six drivers participated in the study (all male) with a mean age of 48 ± 5 years. The prevalence of HROSA was 22.8% out of whom 67.7% also had a EDS. Only 9.6% of the total cohort had EDS without HROSA. Using Fisher's exact test, HROSA was significantly associated with older age (> 50 years, P < .001), obesity (body mass index >30, P < .001), neck circumference of > 40 cm (P = .032), and hypertension (P < .001). Snoring and EDS were significantly associated with RTAs (P < .0001 and P = .007, respectively). CONCLUSIONS High risk of OSA and EDS are common among CMV drivers in Zambia and underdiagnosed. The risk factors for OSA are amenable to preventive interventions. CITATION Simpamba K, May JL, Waghat A, Attarian H, Mateyo K. Obstructive sleep apnea and excessive daytime sleepiness among commercial motor vehicle drivers in Lusaka, Zambia. J Clin Sleep Med. 2023;19(7):1191-1198.
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Affiliation(s)
- Kelvin Simpamba
- Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia
| | - Jasmine L. May
- Department of Neurology, Northwestern University, Chicago, Illinois
| | - Afzal Waghat
- Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia
| | - Hrayr Attarian
- Department of Neurology, Northwestern University, Chicago, Illinois
| | - Kondwelani Mateyo
- Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia
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Ozoh OB, Chakaya J. Awakening sleep disordered breathing in Africa. THE LANCET. RESPIRATORY MEDICINE 2022; 10:812-813. [PMID: 35405142 DOI: 10.1016/s2213-2600(22)00090-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Obianuju B Ozoh
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos Nigeria; Lagos University Teaching Hospital, Lagos, Nigeria.
| | - Jeremiah Chakaya
- Department of Medicine, Therapeutics and Dermatology, Kenyatta University, Nairobi, Kenya; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
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Sleep Apnea Syndrome: Prevalence and Comorbidity with Other Non-communicable Diseases and HIV Infection, among Hospitalized Patients in Yaoundé, Cameroon. SLEEP DISORDERS 2022; 2022:4359294. [PMID: 35186334 PMCID: PMC8853793 DOI: 10.1155/2022/4359294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/28/2021] [Accepted: 01/07/2022] [Indexed: 11/18/2022]
Abstract
Background Sleep apnea syndrome (SAS), a growing public health threat, is an emerging condition in sub-Saharan Africa (SSA). Related SSA studies have so far used an incomplete definition. This study is aimed at assessing SAS using an American Academy of Sleep Medicine (AASM) complete definition and at exploring its relationship with comorbidities, among patients hospitalized in a Cameroonian tertiary hospital. Methods This cross-sectional study was conducted in cardiology, endocrinology, and neurology departments of the Yaoundé Central Hospital. Patients aged 21 and above were consecutively invited, and some of them were randomly selected to undergo a full night record using a portable sleep monitoring device, to diagnose sleep-disordered breathing (SDB). SAS was defined as an apnea − hypopnea index (AHI) ≥ 5/h, associated with either excessive daytime sleepiness or at least 3 compatible symptoms. Moderate to severe SAS (MS-SAS) stood for an AHI ≥ 15/h. We used chi-square or Fisher tests to compare SAS and non-SAS groups. Findings. One hundred and eleven patients presented a valid sleep monitoring report. Their mean age ± standard deviation (range) was 58 ± 12.5 (28–87) years, and 53.2% were female. The prevalence (95% confident interval (CI)) of SAS was 55.0 (45.7, 64.2)% and the one of MS-SAS 34.2 (25.4, 43.1)%. The obstructive pattern (90.2% of SAS and 86.8% of MS-SAS) was predominant. The prevalence of SAS among specific comorbidities ranged from 52.2% to 75.0%. Compared to SAS free patients, more SAS patients presented with hypertension (75.4% vs. 48.0%, p = 0.005%), history of stroke (36.7% vs. 32.0%, p = 0.756), cardiac failure (23.0% vs. 12.0%, p = 0.213), and combined cardiovascular comorbidity (80.3% vs. 52.0%, p = 0.003). Similar results were observed for MS-SAS. Metabolic and neuropsychiatric comorbidities did not differ between SAS and SAS-free patients. Conclusion The SAS diagnosed using modified AASM definition showed high prevalence among patients hospitalized for acute medical conditions, as it was found with SDB. Unlike HIV infection, metabolic and brain conditions, cardiovascular comorbidities (hypertension and cardiac failure) were significantly more prevalent in SAS patients.
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Ade S, Flatin MC, Wachinou PA, Badirou AS, Cissé IM, Adjobimey M, Agodokpessi G, Harries AD. Risk of obstructive sleep apnea among taxi-motorbike drivers in Parakou city in West Africa and associated factors with road traffic accidents. Chron Respir Dis 2022; 19:14799731211063231. [PMID: 35193415 PMCID: PMC8874154 DOI: 10.1177/14799731211063231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Obstructive sleep apnea (OSA) is an underdiagnosed chronic respiratory disease, causing excessive daytime sleepiness (EDS) and road traffic accidents (RTA). This study aimed to determine the risk of OSA among taxi-motorbike drivers (TMD) and factors associated with RTA in Parakou, Benin. METHODS A cross-sectional comparative study was carried out between July and September 2020, including 225 TMD and 450 motorbike drivers other than TMD (non-TMD). A multiple logistic regression was then performed to determine factors associated with RTA. RESULTS The mean age of participants was 38.2 ± 10.2 and 36.6 ±10.9 years, respectively, for TMD and non-TMD (p = .048). The average daily working time was 10.7 ± 2.3H and 9.1±3.5H, respectively, for TMD and non-TMD (p < .001). Average sleeping time was comparable in both groups (7.5±1.4H vs 7.4±1.4H; p = .415). TMD significantly more complained of non-restorative sleep (38.7% vs 18.4%; p < .001) but less of EDS (20.0% vs 28.7%; p = .015). Abdominal obesity predominated in TMD (13.8% vs 4.4%; p < .001). An increased risk of OSA (NoSAS score ≥8) was diagnosed in 25.8% TMD and 26.7% non-TMD (p = .805). Overall, 25.8% of TMD and 18.4% of non-TMD (p = .027) reported at least one RTA in the last 12 months. After adjusted analysis, the unique factor associated with RTA was a daily sleeping pills consumption (aOR=2.2; 95%CI = 1.2-3.8; p = .006). CONCLUSION There is need to improve systematic screening and diagnosis of OSA in both TMD and non-TMD and reinforce the regulation and consumption of sleeping pills.
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Affiliation(s)
- Serge Ade
- Faculty of Medicine, 247620University of Parakou, Parakou, Benin
| | - Marius C Flatin
- Faculty of Medicine, 247620University of Parakou, Parakou, Benin
| | - Prudence A Wachinou
- Faculty of Health Sciences, 107790University of Abomey-Calavi, Cotonou, Benin
| | | | | | - Mênonli Adjobimey
- Faculty of Health Sciences, 107790University of Abomey-Calavi, Cotonou, Benin
| | - Gildas Agodokpessi
- Faculty of Health Sciences, 107790University of Abomey-Calavi, Cotonou, Benin
| | - Anthony D Harries
- International Union Against Tuberculosis and Lung Diseases, Paris, France.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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Sebastian SK, Vaghela JF. Clinical use of STOP-BANG and ESS questionnaires in the evaluation of obstructive sleep apnoea-related risk factors for motor vehicle accidents among public transport drivers in Delhi, India. Sleep Breath 2021; 25:1461-1466. [PMID: 33398795 DOI: 10.1007/s11325-020-02277-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 12/09/2020] [Accepted: 12/16/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the clinical use of Epworth Sleepiness Score (ESS) and STOP-BANG questionnaires in the evaluation of sleep apnoea-related risk factors for motor vehicle accident (MVA) among public transport drivers in Delhi, India. METHODS The present cross-sectional study is based on data collected between April 2018 and March 2019 from public transport drivers in Delhi. All drivers coming for gas filling to 43 compressed natural gas (CNG) stations in Delhi were included in the study. The evaluation of sleep apnoea-related risk factors for motor vehicle accident was done using ESS and STOP-BANG Score. RESULTS A total of 4094 drivers participated in this study, and 299 drivers (7%) gave a history of motor vehicle accidents during the preceding 3 years. Drivers with STOP-BANG score ≥ 3 had a higher risk for MVA (OR 1.59; 95% CI 1.26-2.02; p value < 0.0001). Score of ESS ≥ 10 carried a very high risk for MVA (OR 26.95; 95% CI 16.18-44.87; p value < 0.0001). The other risk factor of significance was alcoholism (OR 1.37; 95% CI 1.04-1.80; p value < 0.0248). CONCLUSION Among public transport drivers in Delhi, daytime sleepiness is the major contributing factor to motor vehicle accidents. ESS and STOP-BANG questionnaires may be good screening tools for the clinical evaluation of OSA. Community-based screening of OSA is required for identification of public transport drivers at high risk of MVA.
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Affiliation(s)
- Susan K Sebastian
- Department of ENT and Head & Neck Surgery, St. Stephen's Hospital, Delhi, 110054, India.
| | - Joyce F Vaghela
- Department of Community Medicine, St. Stephen's Hospital, Delhi, 110054, India
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Abstract
Professional drivers show a higher prevalence of obstructive sleep apnoea (OSA) compared with the general population. Furthermore, there is concern about the association between OSA and car crash risk given that drivers with OSA show an increased risk for car accidents. Despite this risk, OSA is often underdiagnosed and undertreated in this population, mainly due to lack of appropriate screening and sleep study referrals. Polysomnography (PSG), the gold standard test, is inappropriate for systematic screening because of its high expense, complexity and relative inaccessibility in this population. Therefore, there is a strong demand for good screening tools, including both subjective and objective data that may assist in early identification of possible OSA among professional drivers and, thus, aid in PSG examination referral and OSA management in an accredited sleep centre. However, there is considerable disagreement over screening methods and criteria for triggering a sleep study referral in different countries. There is also a strong need for further research in the area of OSA screening of commercial drivers in order to improve the diagnostic accuracy of screening tools and ensure that patients with OSA are accurately identified. OSA is usually undiagnosed and undertreated in professional drivers. Barriers to OSA diagnosis are lack of appropriate screening and sleep study referrals. Screening tools, including both subjective and objective data, may assist in early identification.http://bit.ly/31nD4A9
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Affiliation(s)
- Sophia E Schiza
- Sleep Disorders Center, Dept of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Izolde Bouloukaki
- Sleep Disorders Center, Dept of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
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Awopeju OF, Fawale MB, Olowookere SA, Salami OT, Adewole OO, Erhabor GE. The risk of obstructive sleep apnea and its association with indices of general and abdominal obesity in a Nigerian family practice clinic: a cross-sectional study. ALEXANDRIA JOURNAL OF MEDICINE 2020. [DOI: 10.1080/20905068.2019.1711304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
| | - Michael Bimbo Fawale
- Neurology unit, Department of Medicine, Obafemi Awolowo University, Ile Ife, Nigeria
| | - Samuel Anu Olowookere
- Department of Family Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Nigeria
- Department of Community Health, Obafemi Awolowo University, Ile Ife, Nigeria
| | - Oluwasina Titus Salami
- Department of Family Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Nigeria
| | | | - Gregory Efosa Erhabor
- Respiratory unit, Department of Medicine, Obafemi Awolowo University, Ile Ife, Nigeria
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Reliability and Validity of Simplified Chinese STOP-BANG Questionnaire in Diagnosing and Screening Obstructive Sleep Apnea Hypopnea Syndrome. Curr Med Sci 2019; 39:127-133. [PMID: 30868502 DOI: 10.1007/s11596-019-2010-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 10/09/2018] [Indexed: 12/19/2022]
Abstract
The main purpose of this study was to assess the reliability and validity of the simplified Chinese STOP-BANG Questionnaire (SBQ) as a diagnosing and screening tool for obstructive sleep apnea hypopnea syndrome (OSAHS). Two hundred and ten patients with suspected OSAHS were recruited in this study. The simplified Chinese SBQ was completed twice before and after polysomnography (PSG) monitoring. SPSS 20.0 was used to analyze the test-retest reliability, discriminant validity, comparative validity and predictive validity of the SBQ. Fourteen patients were excluded on account of fragmentary data, and valid 196 were divided into four groups: non-OSAHS group (n=28, 14.29%), mild OSAHS group (n=28, 14.29%), moderate OSAHS group (n=31, 15.81%) and severe OSAHS group (n=109, 55.61%). The test-retest coefficient for the first four items was 0.810, 0.679, 0.775, 0.963 respectively and the total score of the STOP questionnaire was 0.854. The analysis of discriminant validity revealed that there were significant differences among four groups in the total score of the SBQ and scores of item 1, 3, 7 and 8, which were also validated between patients with normal blood oxygen saturation and different degrees of hypoxemia. The SBQ evaluation showed low consistency with diagnostic gold standard PSG (κ=0.303, P<0.05). When taking apnea hypopnea index (AHI) ≥5/h, ≥15/h and ≥30/h as cut-offs to evaluate the SBQ predictive value, the areas under ROC curve were 0.77, 0.81 and 0.78, the sensitivity was 90.48%, 93.57% and 93.33%, and corresponding negative predictive values were 40.74%, 66.67% and 85.19%, respectively. It was suggested that the simplified Chinese version of SBQ had good reliability, and could distinguish the severity of OSAHS. Despite its limited diagnostic accuracy, the SBQ can be considered as an ideal tool for screening OSAHS with superior predictive validity.
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Fadeyi BA, Ayoka AO, Fawale MB, Alabi QK, Oluwadaisi AM, Omole JG. Prevalence, predictors and effects of shift work sleep disorder among nurses in a Nigerian teaching hospital. SLEEP SCIENCE AND PRACTICE 2018. [DOI: 10.1186/s41606-018-0027-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Amadi CE, Grove TP, Mbakwem AC, Ozoh OB, Kushimo OA, Wood DA, Akinkunmi M. Prevalence of cardiometabolic risk factors among professional male long-distance bus drivers in Lagos, south-west Nigeria: a cross-sectional study. Cardiovasc J Afr 2018; 29:106-114. [PMID: 29457826 PMCID: PMC6008896 DOI: 10.5830/cvja-2018-006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 01/14/2018] [Indexed: 12/30/2022] Open
Abstract
Background Professional drivers are known to be at high risk of cardiovascular disease (CVD). This study was carried out to highlight these risk factors and their predictors among male long–distance professional bus drivers in Lagos, southwest Nigeria, with a view to improving health awareness in this group. Methods Socio–demographic data, anthropometric indices, blood pressure, fasting plasma blood glucose levels and lipid and physical activity profiles of 293 drivers were measured. Results Mean age of the study population was 48 ± 9.7 years; 71.0 and 19.5% of the drivers used alcohol and were smokers, respectively; and 50.9% were physically inactive. The prevalence of overweight and obesity was 41.7 and 21.1%, respectively, while 39.7 and 13.9% were hypertensive and diabetic, respectively. Ninety (31.3%) subjects had impaired fasting glucose levels while 56.3% had dyslipidaemia. Predictors of hypertension were age and body mass index (BMI). BMI only was a predictor of abnormal glucose profile. Conclusion Professional male long–distance bus drivers in this study showed a high prevalence of a cluster of risk factors for CVD.
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Affiliation(s)
- Casmir E Amadi
- Department of Medicine, College of Medicine, University of Lagos, Nigeria.
| | - Tim P Grove
- National Heart and Lung Institute, Imperial College, London
| | - Amam C Mbakwem
- Department of Medicine, College of Medicine, University of Lagos, Nigeria
| | - Obianuju B Ozoh
- Department of Medicine, College of Medicine, University of Lagos, Nigeria
| | | | - David A Wood
- National Heart and Lung Institute, Imperial College, London
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Gupta R, Pandi-Perumal SR, Almeneessier AS, BaHammam AS. Hypersomnolence and Traffic Safety. Sleep Med Clin 2017; 12:489-499. [PMID: 28778244 DOI: 10.1016/j.jsmc.2017.03.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many people die or become disabled because of motor vehicle accidents. Scientific data suggest that sleepy drivers or those driving at odd hours are more likely to make driving mistakes. Patients with obstructive sleep apnea and narcolepsy have been found to exhibit higher rates of falling asleep while driving. Treatment enhances the vigilance of these drivers. Tests measuring the extent of daytime sleepiness or drowsiness while driving can help identify at-risk drivers. There is a need to develop clear regulations governing periodic assessment of drivers' risks of falling asleep at the wheel, especially commercial drivers.
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Affiliation(s)
- Ravi Gupta
- Department of Psychiatry & Sleep Clinic, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Doiwala, Dehradun, India
| | | | - Aljohara S Almeneessier
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh 11324, Saudi Arabia
| | - Ahmed S BaHammam
- University Sleep Disorders Center, Department of Medicine, College of Medicine, King Saud University, Box 225503, Riyadh 11324, Saudi Arabia.
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Correlates of sleep quality and sleep duration in a sample of urban-dwelling elderly Nigerian women. Sleep Health 2017; 3:257-262. [PMID: 28709512 DOI: 10.1016/j.sleh.2017.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 05/14/2017] [Accepted: 05/17/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Aging, female sex, and urbanization increase the risk of sleep impairment. Sleep in urban-dwelling elderly African women has been sparsely studied. We studied the characteristics and correlates of sleep quality and habitual sleep duration in a primary care population of urban-living Nigerian women. METHODS Sleep quality and sleep duration over the previous 1 month were estimated using the Pittsburgh Sleep Quality Index (PSQI). Excessive daytime sleepiness, risk of obstructive sleep apnea (OSA), and depressive symptoms were also assessed. RESULTS Of the 428 subjects included, 117 (27.3%) were poor sleepers endorsing PSQI scores >5, whereas 126 (29.4%) slept <7 hours. The poor sleepers were more likely to be obese (P = .022), to have a high risk for OSA (P = .013), and to have clinically significant depressive symptoms (P = .001) compared with the good sleepers. Habitual sleep duration of <7 hours was associated with past oral contraceptive use (P = .025) and a trend toward a higher likelihood of high risk for OSA (P = .05) and coffee consumption (P = .05). On regression, the odds of high risk for OSA were higher with poor sleep quality and sleep duration <7 hours, respectively, whereas the odds of coffee consumption were higher with sleep duration <7 hours. CONCLUSIONS Poor sleep quality and inadequate sleep are common in our population of elderly women. High risk for OSA independently predicts poor sleep quality and, along with report of coffee consumption, independently predicts habitual sleep duration of <7 hours.
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Is the knowledge and attitude of physicians in Nigeria adequate for the diagnosis and management of obstructive sleep apnea? Sleep Breath 2016; 21:521-527. [DOI: 10.1007/s11325-016-1407-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 08/18/2016] [Accepted: 09/07/2016] [Indexed: 10/21/2022]
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Fawale MB, Ibigbami O, Ismail I, Mustapha AF, Komolafe MA, Olamoyegun MA, Adedeji TA. Risk of obstructive sleep apnea, excessive daytime sleepiness and depressive symptoms in a Nigerian elderly population. ACTA ACUST UNITED AC 2016; 9:106-11. [PMID: 27656275 PMCID: PMC5021957 DOI: 10.1016/j.slsci.2016.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 05/09/2016] [Accepted: 05/20/2016] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To evaluate the risk of obstructive sleep apnea (OSA) in a primary care population of elderly Nigerians and to determine its correlates. METHODS Clinical and demographic data of 414 elderly individuals in a primary care clinic were obtained. Their risk of OSA was estimated using Berlin questionnaire while Epworth sleepiness scale and the Center for Epidemiologic Studies Depression Scale (CESD-10) were also administered. RESULTS Of the 414 subjects, 96 (23.2%) met the criteria for a high risk for OSA with a male to female ratio of 1:1. Subjects at high OSA risk (high OSA risk group) were younger than those at low OSA risk (low OSA risk group) (71.4±6.8 vs 73.6±7.7, p=0.011). Mean body mass index (BMI, kg/m(2)) (27.3±5.8 vs 24.7±5.1, p<0.001) and waist circumference (WC, cm) (90.7±13.1 vs 86.5±13.9, p=0.011) were higher in the high OSA risk group compared with the low OSA risk group. A total of 215 (51.9%) and 62 (15.0%) subjects had clinically significant depressive symptoms (CESD-10 score≥10) and excessive daytime sleepiness (EDS), respectively. On regression, the odds of EDS, depressive symptoms, increased BMI and younger age were significantly higher in the high OSA risk group compared with the low OSA risk group. CONCLUSIONS High risk for OSA and depressive symptoms are common in our sample of elderly Nigerians. Depressive symptoms, EDS, BMI and age independently predict high OSA risk in the elderly.
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Affiliation(s)
- Michael B. Fawale
- Neurology Unit, Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
- Corresponding author.
| | | | - Ishaq Ismail
- Department of Family Medicine, State Hospital, Ilesa, Nigeria
| | - Adekunle F. Mustapha
- Neurology Unit, Department of Medicine, College of Health Sciences, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Morenikeji A. Komolafe
- Neurology Unit, Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Michael A. Olamoyegun
- Endocrinology Unit, Department of Medicine, College of Health Sciences, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Tewogbade A. Adedeji
- Department of Chemical Pathology, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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Chung F, Abdullah HR, Liao P. STOP-Bang Questionnaire. Chest 2016; 149:631-8. [DOI: 10.1378/chest.15-0903] [Citation(s) in RCA: 542] [Impact Index Per Article: 67.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 08/19/2015] [Accepted: 08/22/2015] [Indexed: 01/14/2023] Open
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Nagappa M, Liao P, Wong J, Auckley D, Ramachandran SK, Memtsoudis S, Mokhlesi B, Chung F. Validation of the STOP-Bang Questionnaire as a Screening Tool for Obstructive Sleep Apnea among Different Populations: A Systematic Review and Meta-Analysis. PLoS One 2015; 10:e0143697. [PMID: 26658438 PMCID: PMC4678295 DOI: 10.1371/journal.pone.0143697] [Citation(s) in RCA: 349] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 11/09/2015] [Indexed: 11/18/2022] Open
Abstract
Background Diagnosing obstructive sleep apnea (OSA) is clinically relevant because untreated OSA has been associated with increased morbidity and mortality. The STOP-Bang questionnaire is a validated screening tool for OSA. We conducted a systematic review and meta-analysis to determine the effectiveness of STOP-Bang for screening patients suspected of having OSA and to predict its accuracy in determining the severity of OSA in the different populations. Methods A search of the literature databases was performed. Inclusion criteria were: 1) Studies that used STOP-Bang questionnaire as a screening tool for OSA in adult subjects (>18 years); 2) The accuracy of the STOP-Bang questionnaire was validated by polysomnography—the gold standard for diagnosing OSA; 3) OSA was clearly defined as apnea/hypopnea index (AHI) or respiratory disturbance index (RDI) ≥ 5; 4) Publications in the English language. The quality of the studies were explicitly described and coded according to the Cochrane Methods group on the screening and diagnostic tests. Results Seventeen studies including 9,206 patients met criteria for the systematic review. In the sleep clinic population, the sensitivity was 90%, 94% and 96% to detect any OSA (AHI ≥ 5), moderate-to-severe OSA (AHI ≥15), and severe OSA (AHI ≥30) respectively. The corresponding NPV was 46%, 75% and 90%. A similar trend was found in the surgical population. In the sleep clinic population, the probability of severe OSA with a STOP-Bang score of 3 was 25%. With a stepwise increase of the STOP-Bang score to 4, 5, 6 and 7/8, the probability rose proportionally to 35%, 45%, 55% and 75%, respectively. In the surgical population, the probability of severe OSA with a STOP-Bang score of 3 was 15%. With a stepwise increase of the STOP-Bang score to 4, 5, 6 and 7/8, the probability increased to 25%, 35%, 45% and 65%, respectively. Conclusion This meta-analysis confirms the high performance of the STOP-Bang questionnaire in the sleep clinic and surgical population for screening of OSA. The higher the STOP-Bang score, the greater is the probability of moderate-to-severe OSA.
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Affiliation(s)
- Mahesh Nagappa
- Department of Anesthesiology, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Pu Liao
- Department of Anesthesiology, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Jean Wong
- Department of Anesthesiology, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Dennis Auckley
- Division of Pulmonary, Critical Care and Sleep Medicine, Metro Health Medical Center, Case Western Reserve University, Cleveland, OH, United States of America
| | - Satya Krishna Ramachandran
- Department of Anesthesiology, University of Michigan Health System, East Medical Center Drive, Michigan, United States of America
| | - Stavros Memtsoudis
- Department of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, United States of America
| | - Babak Mokhlesi
- Department of Medicine, Sleep Disorders Center and the Section of Pulmonary and Critical Care, University of Chicago, Chicago, Illinois, United States of America
| | - Frances Chung
- Department of Anesthesiology, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
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Bawo OJ, Chinwe FI, Atim OA. Risk of obstructive sleep apnoea syndrome among in-patients at a neuropsychiatric hospital in Nigeria: a short report. Afr Health Sci 2015; 15:967-71. [PMID: 26957988 DOI: 10.4314/ahs.v15i3.34] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND/OBJECTIVES Sleep problems are commonly reported by persons with severe mental illness. Obstructive sleep apnoea syndrome (OSA) is commonly co-morbid with mental illness. Screening for OSA and its subsequent management may improve outcomes in this patient population. We screened for risk of OSA among in-patients with severe mental illness to determine its prevalence as well as its correlates using a socio-demographic questionnaire and the Berlin questionnaire. METHODS A cross sectional descriptive exploratory survey of in-patients (n=89) at a regional Neuro- Psychiatric hospital using a socio-demographic questionnaire and the Berlin questionnaire. RESULTS Eighteen patients (18/89; 20.9%) were classed as high risk for OSA. High risk for OSA was significantly associated with a higher body mass index; BMI (p<0.01), but not gender (p=0.53), diagnoses (p=0.84), co-morbidity (p=0.73) or use of atypical antipsychotics (p=0.48). CONCLUSION Patients with severe mental illness are at high risk for OSA with being overweight higher BMI significantly associated with this high risk.
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The relationship between driving simulation performance and obstructive sleep apnoea risk, daytime sleepiness, obesity and road traffic accident history of commercial drivers in Turkey. Sleep Breath 2015; 19:865-72. [DOI: 10.1007/s11325-014-1114-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 11/24/2014] [Accepted: 12/23/2014] [Indexed: 10/24/2022]
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