Obstructive sleep apnea hypopnea syndrome was a risk factor for uncontrolled hypertension in adult snorers in South China.

BACKGROUND: The association of obstructive sleep apnea hypopnea syndrome (OSAHS) with uncontrolled hypertension has not been fully investigated to date. The present article will investigate the associated factors of uncontrolled hypertension in South China Method: A total of 668 patients (531 males, 137 females) in South China were enrolled in this study. All patients completed questionnaires and then underwent an in-hospital polysomnography. RESULT: Univariate analysis showed that drinking, apnea-hypopnea index, Epworth Sleepiness Scale (ESS) index, the presence of OSAHS, MSaO2 and the lowest SaO2, circumference of neck and waist were predictors of uncontrolled hypertension. Multiple logistic regression analysis showed that ESS, presence of OSAHS, and the lowest SaO2 was independently associated with the risk for uncontrolled hypertension. CONCLUSION: The lowest SaO2, ESS index, and OSAHS were risk factors for uncontrolled hypertension.

[Analysis of clinical characteristics and risk factors of obstructive sleep apnea hypopnea syndrome with hypertension].

OBJECTIVE: To study the risk factors contributing to the development of hypertension in patients with obstructive sleep apnoea hypopnea syndrome (OSAHS), and the clinical characteristics of OSAHS with hypertension. METHODS: A total of 2397 OSAHS patients aged above 30 years old and diagnosed by the sleep-disordered breathing center of Guangxi between July 2012 and August 2015 were recruited. OSAHS patients with new-onset hypertension (OSAHS with hypertension group) and those without hypertension (simple OSAHS group) were identified and their clinical data, including general status, family history of hypertension or snoring, Epworth Sleepiness Scale (ESS) score for daytime sleepiness, physical examination findings, and polysomnography monitoring data were collected. OSAHS patients with new-onset hypertension (n=101) and OSAHS patients without hypertension (n=202) matched by age and body mass index (BMI) (age difference, 2 years; BMI difference, 1.5 kg/m(2)) were recruited in the OSAHS with hypertension group and the simple OSAHS group. A case-control study was used to compare the clinical characteristics of these two groups, and univariate and multivariate Logistic regression were used to analyze all the factors contributing to hypertension development besides age and BMI. RESULTS: The average age and BMI of the OSAHS with hypertension group and the simple OSAHS group were respectively (46.2±9.3), (46.2±9.2) years old and (28.2±2.8), (28.2±2.8) kg/m(2). Patients in the two groups were well-matched with respect to age and BMI (P>0.05). The systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the OSAHS with hypertension group were significantly higher than those in the simple OSAHS group at the first admission to the clinic and before and after the PSG examination. ESS values in the OSAHS with hypertension group and the simple OSAHS group were respectively 10.0±6.4 and 9.2±6.3 (P>0.05). There was no significant intergroup difference in neck circumference, waist circumference, duration of snoring, family history of snoring, and family history of hypertension (P>0.05) either. The apnea-hypopnea index (AHI) and apnea index (AI) in the OSAHS with hypertension group were higher than those in the simple OSAHS group (P<0.05); the longest apnea duration (LAD), mean apnea duration (MAD), and the total time spent with oxygen saturation below 90% (T90%) in the OSAHS with hypertension group were significantly longer than those in the simple OSAHS group (P<0.05). The minimal pulse oxygen saturation (MinSpO2) in the OSAHS with hypertension group was significantly lower than that in the simple OSAHS group (P<0.05). Six factors were identified to be associated with OSAHS with hypertension through univariate analysis: AHI (OR=0.985, P=0.001), AI (OR=0.983, P<0.001), LAD (OR=0.955, P=0.013), MAD (OR=0.874, P=0.015), MinSpO2 (OR=0.874, P=0.015), T90% (OR=0.997, P=0.036). Only MinSpO2 (P<0.001, OR=0.894) was closely related to OSAHS hypertension development in the multivariate Logistic regression model. CONCLUSIONS: OSAHS patients with hypertension may show lower MinSpO2, higher AHI and AI, and longer LAD, MAD, and T90% than OSAHS patients without hypertension. MinSpO2 is probably closely related to OSAHS hypertension development.

[Simple three-variable screening tool for identification of patients with obstructive sleep apnea-hypopnea syndrome in middle-aged male snorers from Guangxi region: a multi-center study].

OBJECTIVE: To evaluate the correlation between three variables of neck circumference, body mass index (BMI) and Epworth sleepiness scale (ESS) and obstructive sleep apnea-hypopnea syndrome (OSAHS) and the value of three-variable screening tool among snorers in Guangxi region. METHODS: From May 2009 to June 2014, 2 955 middle-aged consecutive patients with snoring were recruited from four hospitals of Guangxi Province. All subjects underwent polysomnography (PSG) and physical examinations including neck circumference, BMI and ESS. The diffrences of neck circumference, BMI and ESS were compared between OSAHS and non-OSAHS groups; the correlation between apnea-hypopnea index (AHI) and neck circumference, BMI and ESS were analyzed. The optimal cutoff point of three variables was selected by SPSS's Optimal Binning methods and screening score was assigned according to the Logistic regression coefficient. The recommended cutoff points were neck circumference ≥ 38.5 cm (3 points), BMI ≥ 25.7 kg/m(2) (5 points), ESS ≥ 9 points (1 point) for males and neck circumference ≥ 34.5 cm (5 points), BMI ≥ 24.5 kg/m(2) (2 points), ESS ≥ 7 points (1 points) for females. The best integral value was obtained through the receiver operating characteristic (ROC) curve. RESULTS: A total of 2 803 subjects fulfilled the study criteria. There were 2 366 males and 437 females. The average values of neck circumference, BMI and ESS were (38.7 ± 3.5) cm, (27.3 ± 3.6) kg/m(2) and (8.6 ± 5.4) score respectively. Both males and females had a positive association between AHI and neck circumference, BMI and ESS (r = 0.389, 0.485, 0.293, 0.386, 0.439 and 0.291 respectively, all P < 0.001). For males, at an integral value ≥ 6, the sensitivity was 71.4% in the diagnosis of OSAHS, specificity 65.5% and positive predictive value 91.1%. For females, at an integral value ≥ 3, the sensitivity was 73.3% in the diagnosis of OSAHS, specificity 63.6% and positive predictive value 66.3%. CONCLUSIONS: In middle-aged snorers in Guangxi, neck circumference, BMI and ESS are correlated with OSAHS. And a positive association exists between AHI and neck circumference, BMI and ESS. Simple three-variable screening tool is highly valuable for diagnosing OSAHS, especially among male snorers.

Prevalence of signs and symptoms suggestive of obstructive sleep apnea syndrome in Guangxi, China.

BACKGROUND: The prevalence, profiles, and potential risk factors of snoring and obstructive sleep apnea-hypopnea syndrome (OSAHS) in China are largely unknown. OBJECTIVES: This study aims to investigate the prevalence, profiles, and potential risk factors for snoring and OSAHS in Guangxi, China, and the association between OSAHS and ethnicity. METHODS: Urban and rural population-based cluster samples were randomly selected in each of eight counties/cities. All residents aged 14 years or older in the selected clusters were interviewed using a standardized questionnaire. A subject was considered to have clinically diagnosed OSAHS if snoring was loud and habitual, breathing pauses were observed, and the subject experienced excessive daytime sleepiness. RESULTS: Among 12,742 sampled subjects, 10,819 completed the questionnaire (response rate = 84.9%). The overall OSAHS prevalence was 4.1% (men, 5.7% (5.1-6.3%); women, 2.4% (2.0-2.9%); Zhuang people, 3.2% (2.8-3.7%); Han people 6.0% (5.2-6.8%).The overall rate of habitual snoring was 11.5 % (men, 17.1% (16.1-18.1%); women, 5.6% (5.0-6.2%)). Univariate analysis showed that the OSAHS prevalence was significantly higher among the following groups: urban residents, elderly individuals, smokers, drinkers, those with higher body mass indexes (BMI), those with more years of schooling, those with nasal problems, those whose parents are Han, and those who usually sleep in prone position. However, multiple logistic regression analysis revealed that only urban residency, age, smoking status, drinking status, and BMI were the risk factors for OSAHS. CONCLUSIONS: OSAHS is prevalent in individuals aged 14 years or older in Guangxi, China. Han and Zhuang people differ significantly in their obstructive sleep apnea (OSA) prevalence, but this difference is explained by the combination of classic OSA risk factors.

[Correlation of smoking and obstructive sleep apnea and hypopnea syndrome].

OBJECTIVE: To explore the correlation between smoking and obstructive sleep apnea and hypopnea syndrome (OSAHS). METHODS: The data were collected from a chart review of patients with sleep or sleep-breathing disorders undergoing overnight polysomnography (PSG) at Sleep-Disordered Breathing Center of Guangxi from July 1, 2009 to June 30, 2012. Smoking history was quantified by retrospective questionnaires. A definite diagnosis of OSAHS was defined by an apnea-hypopnea index (AHI) (events/h) of > 15 events per hour. And those with AHI (events/h) between 5 and 15 were eliminated. The non-OSAHS subjects were defined by an AHI (events/h) <5 events per hour. The association of smoking status and severity with OSAHS was analyzed. RESULTS: A total of 903 patients were excluded from 2 243 patients. The recruited subjects were divided into OSAHS (n = 929) and non-OSAHS (n = 411) groups. Smoking prevalence in OSAHS group was 47.1% versus 25.5% in non-OSAHS group. Logistic regression analyses were performed to examine the effects of smoking habits while adjusting for age, gender, body mass index (BMI) and drinking history. Current smokers were 1.446 times more likely to have OSAHS than non-smokers (95% CI: 1.079-1.939, P = 0.013). Current smokers with pack-years ≥ 30 were more 2.382 times more likely to have OSAHS than non-smokers to have OSAHS (95% CI: 1.127-4.375, P = 0.012). Current smokers diagnosed as having OSAHS with pack-years ≥ 30 had a more percentage of total sleep time (TST) spent with saturation of oxyhemoglobin (SaO2)<90% ((20.5 ± 23.1)% vs (15.6 ± 18.8)%, P = 0.004) and lower average SaO2 ((69.4 ± 10.3)% vs (73.2 ± 9.7)%, P = 0.000) during sleep than non-smokers diagnosed as having OSAHS. Current smokers diagnosed as having OSAHS with pack-years ≥ 30 were 1.893 times more likely to spend > 5% of TST at SaO2<90% than non-smokers diagnosed as having OSAHS (95% CI: 1.046-3.423, P = 0.035). CONCLUSIONS: Smoking is associated with a significantly increased risk of OSAHS and nocturnal hypoxia in current smokers, especially those with ≥ 30 pack-years. And it exacerbates nocturnal hypoxia in OSAHS patients.

[A statistical study of the blood pressure in snoring population of Guangxi].

OBJECTIVE: To study the prevalence of snoring, the blood pressure in the snoring population and the correlating between hypertension and snoring in Guangxi. METHODS: From January 2003 to March 2005, people older than 14 from the south, central and north Guangxi were studied for the prevalence of snoring. A questionnaire was administered, and the blood pressure, height and weight of the participants were measured. RESULTS: A total of 2862 families, 11 163 persons (aged 14 - 99 years, mean, 39.6 +/- 17.5 years) were surveyed. The prevalence of snoring was 27.3% (2940/10 758). The systolic blood pressure and the diastolic blood pressure of the non-snoring were 122.73 +/- 21.71 mm Hg and 75.68 +/- 13.17 mm Hg respectively. The systolic blood pressure and the diastolic blood pressure of the snoring were 128.23 +/- 30.85 mm Hg and 79.27 +/- 12.42 mm Hg respectively. The prevalence of hypertension of the two groups was 19.9% and 32.1% respectively. With the increase of age, there was an increasing tendency of snoring rate (tendency chi(2) = 592.613, P = 0.000) and hypertension rate (tendency chi(2) = 1868.277, P = 0.000). The hypertension incidence of the occasional snorers, habitual snorers, mild snorers, moderate snorers, and severe snorers and persons who suffered from sleep apnea was 27.6%, 37.4%, 27.5%, 31.1%, 37.4% and 44.1% respectively. Multiple logistic regression models showed that the risk factors for hypertension were snoring, age, body mass index (BMI), nationality and alcohol consumption. The partial correlation analysis showed that snoring was positively correlated to the diastolic blood pressure but not correlated to the systolic blood pressure. The severity of snoring was positively correlated to both the diastolic and the systolic blood pressures. CONCLUSIONS: The prevalence of snoring was 27.3% in Guangxi. The systolic blood pressure, the diastolic blood pressure and the prevalence of hypertension in snoring subjects were higher than those in non-snoring subjects. The prevalence of hypertension increased with increased severity of snoring. The severity of snoring was positively correlated to the diastolic and the systolic blood pressures. Snoring, age, BMI and alcohol consumption were the risk factors for hypertension.

[Study on the prevalence of snoring and obstructive sleep apnea-hypopnea syndrome in Guangxi, China].

OBJECTIVE: To study the prevalence of snoring and obstructive sleep apnea-hypopnea syndrome (OSAHS) and its high risk factors in Guangxi Zhuang Autonomous Region. METHODS: From January 2003 to March 2005, a total number of 11,163 persons aged > or =14 years Zhuang minority living in Guangxi (from Guinan, Guizhong and Guibei) were surveyed. Questionnaire was administered to draw information. Polysomnography(PSG) and in-home polygraphy were performed on participants being studied and who had reported snoring. RESULTS: Among all the surveyed people, 2940reported snoring with a prevalence of 27.3%. 448 (320 males and 128 females) people reported OSAHS with prevalence as 4.3% (5.9% in males and 2.5% in females). From 14 to 60 year olds, the prevalence of snoring and OSAHS increased with age. Among those above 60 years of age, both the prevalencerates ofsnoring and OSAHS werereduced with age. Among all the study population, 260 (21.6%) had habitual OSAHS a nd 188 (10.8%) hadoccasional OSAHS. The high risk factors of OSAHS were: position during sleep, disease of nose, drinking alcohol, smoking, gender, body mass index (BMI) and age. CONCLUSION: The prevalence rates of snoring and OSAHS were 27.3% and 4.3% respectively. From 14 to 60 years of age, the prevalence rates of snoring and OSAHS were increasing with age while from 60 years of age on, the prevalence of snoring and OSAHS reduced with age. The prevalence rates of snoring and OSAHS in males were higher than females. The high risk factors of OSAHS were position during sleep,disease of nose, drinking, smoking,gender, BMI and age.