Prevalence of Sleep-disordered Breathing and Sleep Apnea in Middle-aged Urban Indian Men

TLDR

No data exist on the prevalence of sleep‑disordered breathing (SDB) and obstructive sleep apnea‑hypopnea syndrome (OSAHS) in Indians. The study aimed to determine the prevalence of SDB and OSAHS among healthy urban Indian men aged 35‑65 and to identify risk factors and questionnaire items that best predict OSAHS. A two‑phase cross‑sectional design was used: 658 men completed sleep questionnaires, and 250 of them underwent overnight home sleep studies. SDB and OSAHS prevalence were 19.5 % and 7.5 %, respectively, with BMI, neck girth, and diabetes predicting SDB, and snoring, choking, unrefreshing sleep, awakenings, hypersomnolence, and fatigue predicting OSAHS, highlighting a significant public‑health burden.

Abstract

No data are available on the prevalence of sleep-disordered breathing (SDB) and obstructive sleep apnea-hypopnea syndrome (OSAHS) in Indians. We conducted a two-phase cross-sectional prevalence study for the same in healthy urban Indian males (35-65 years) coming to our hospital in Bombay for a routine health check. We also investigated its risk factors and evaluated the significance of the most commonly asked questions that best correlated with the presence of OSAHS. In the first phase, 658 subjects (94%) returned completed questionnaires regarding their sleep habits and associated medical conditions. In the second phase, 250 of these underwent an overnight home sleep study. The estimated prevalence of SDB (apnea-hypopnea index of 5 or more) was 19.5%, and that of OSAHS (SDB with daytime hypersomnolence) was 7.5%. Multiple stepwise logistic regression determined body mass index, neck girth, and history of diabetes mellitus as the principal covariates of SDB. The presence of snoring, nocturnal choking, unrefreshing sleep, recurrent awakening from sleep, daytime hypersomnolence, and daytime fatigue was each statistically significant for identifying patients with OSAHS. The higher prevalence of OSAHS in urban Indian men is striking and may have major public health implications in a developing country.