Awareness of obstructive sleep apnea-hypopnea syndrome among the general population of the Lorraine Region of France

Knowledge of Obstructive Sleep Apnea Among the General Population in Arar, Northern Region of Saudi Arabia

BACKGROUND

Obstructive sleep apnea (OSA) can have serious health consequences if left untreated, including an increased risk of heart disease, stroke, and diabetes. Raising awareness about this condition can help reduce the stigma surrounding sleep disorders and encourage individuals to seek help if they suspect they may have OSA. It is important for the general population to be informed about this condition in order to promote better overall health and well-being.

OBJECTIVE

To assess the level of knowledge of OSA among the general population of Arar, Northern region of Saudi Arabia.

METHODOLOGY

 This study is a cross-sectional descriptive study to assess the knowledge of OSA in the general population in the northern region of Saudi Arabia. We used an online self-administered questionnaire to collect sociodemographic data and questions about the subject's awareness.

RESULTS

Four hundred thirty-nine individuals participated in this study. The majority of them 337 (76.8%) were female. About 181 (41.2%) of the studied participants were in the age category of 15-25 years and 66.3% had heard about sleep apnea. Nearly 316 (72%) reported that sleep apnea is considered dangerous. Snoring, low sleep quality, and coughing were the main symptoms of sleep apnea. Moreover, obesity, smoking, and chronic diseases were the main causes of sleep apnea, according to the participants' knowledge. About 37 (8.4%) of participants said that they were diagnosed with sleep apnea, and 30 (6.8%) of them revealed that sleep apnea affected their quality of life.

CONCLUSION

Knowledge of OSA in Saudi Arabia is considered inadequate. General population knowledge of OSA can be improved through a multi-faceted approach that involves public education campaigns, continuous medical education for healthcare professionals, and policy-level interventions.

Validation of the STOP-Bang questionnaire for screening of obstructive sleep apnea in the general population and commercial drivers: a systematic review and meta-analysis

Purpose

Obstructive sleep apnea (OSA) is a critical occupational health concern, but is often undiagnosed in the general population and commercial drivers. The STOP-Bang questionnaire is a simple, reliable tool to screen for OSA, which could improve public health in a cost-effective manner. The objective of this systematic review and meta-analysis is to assess the validity of the STOP-Bang questionnaire to detect OSA in these key populations.

Methods

We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, PsycINFO, Journals @ Ovid, Web of Science, Scopus, and CINAHL for relevant articles from 2008 to March 2020. The quality of studies was appraised using Cochrane Methods criteria. To calculate pooled predictive parameters, we created 2 × 2 contingency tables and performed random-effects meta-analyses.

Results

Of 3871 citations, five studies that evaluated STOP-Bang in the general population (n = 8585) and two in commercial drivers (n = 185) were included. In the general population, prevalence of all OSA (AHI ≥ 5), moderate-to-severe OSA (AHI ≥ 15), and severe OSA (AHI ≥ 30) was 57.6%, 21.3%, and 7.8% respectively. In commercial drivers, the prevalence of moderate-to-severe OSA was 37.3%. The trends of high sensitivity and negative predictive value of a STOP-Bang score ≥ 3 illustrates that the questionnaire helps detect and rule out clinically significant OSA in the general population and commercial drivers.

Conclusion

This meta-analysis demonstrates that the STOP-Bang questionnaire is a valid and effective screening tool for OSA in the general population and commercial drivers.

Trial registration

PROSPERO No. CRD42020200379; 08/22/2020

Supplementary Information

The online version contains supplementary material available at 10.1007/s11325-021-02299-y.

Determination of risks of lower adherence to CPAP treatment before their first use by patients

A better understanding of Continuous Positive Airway Pressure (CPAP) adherence is a priority in improving patient care. To Identify adherence typology with a longitudinal approach, and explore the early determinants of lower adherence to CPAP. Obstructive sleep apnea patients (N = 204). Prospective and longitudinal study.A classification into four profiles was observed: "Regular Adherents," "Non-Regular Adherents," "Persistent Non-Adherents," and "Non-Persistent Non-Adherents." Specific biopsychosocial factors make it possible to evaluate the risk of belonging to a lower adherence profile. We propose a novel approach of CPAP treatment adherence. Several pre-determinants have been identified.

Threshold of the upper airway cross-section for hypopnea onset during sleep and its identification under waking condition

Background

There is currently no method that can predict whether or under what condition hypopnea, even obstructive sleep apnea (OSA), will occur during sleep for individuals based on credible parameters measured under waking condition. We propose a threshold concept based on the narrowest cross-sectional area of the upper airway (CSA-UA) and aim to prove our hypothesis on the threshold of the area for hypopnea onset (TAHO), which can be used as an indicator of hypopnea onset during sleep and measured while awake.

Methods

We performed magnetic resonance imaging for 20 OSA patients to observe CSA-UA changes during fluid accumulation in the neck caused by elevating their legs, and identified TAHO by capturing the sudden enlargement in CSA-UA. Correlation analyses between TAHO and the body mass index (BMI), and between the reduction in CSA-UA and the increase in the neck circumference (NC) with fluid accumulation were performed. Logistic regression analysis was performed for identifying OSA patients based on the behaviors of their CSA-UA changes during leg raising. Shape changes of airway cross-section were also investigated.

Results

Four CSA-UA change patterns after fluid redistribution were identified. Six patients had similar CSA-UA variation behaviors observed in healthy subjects. From the other three change patterns involving 14 patients, a threshold value of CSA-UA 0.63 ± 0.21 cm² was identified for normal breathing. Data showed a positive correlation between TAHO and BMI (r = 0.681, p = 0.0007), and a negative correlation between the reduction in CSA-UA and the increase in NC (r = − 0.513, p = 0.051) with fluid accumulation. A sigmoid function for the probability of being a OSA patient p = 1/[1 + exp. (4.836 + 3.850 t-8.4 h)] was obtained to effectively separate OSA patients from normal subjects. The upper airway narrowing occurred in anteroposterior, lateral, or both directions, suggesting different tendencies of upper airway collapse in patients. Three types of shape changes in the cross-section of the upper airway, which had different effects on airway resistance, were measured.

Conclusions

Our findings prove TAHO hypothesis. The threshold measured while awake for normal breathing can be used clinically as the indicator of hypopnea onset during sleep, and therefore to identify OSA patients under waking condition and design effective personalized treatments for OSA patients. Both shape and size changes in the cross-section of the upper airway affect airway resistance significantly. Shape change in the cross-section of the upper airway can provide key clinical information on the collapse patterns of the upper airway for individuals.