Prospective study of the prevalence and co-morbidities of obstructive sleep apnea in active-duty army personnel in the three southernmost provinces of Thailand using questionnaire screening
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摘要
Background: It is crucial for the army to know the prevalence of obstructive sleep apnea(OSA) syndrome in activeduty army personnel. Little information has been reported on the prevalence of OSA and clinical features in activeduty army personnel. This study was aimed to estimate the prevalence of snoring and risk of developing OSA in activeduty army personnel in Thailand and to identify the co-morbidities of OSA. In total, 1107 participants who were aged20–60 years and were deployed to the three southernmost provinces of Thailand were enrolled. All the participants completed the Phramongkutklao(PMK) Hospital OSA Questionnaire that was modified and validated from the Berlin Questionnaire and underwent physical examination. The participants were 1107 active-duty army personnel in the three southernmost provinces of Thailand, both males and females, aged 20–60 years.Methods: The PMK OSA Questionnaire was used to assess the risk of OSA together with interviewing for snoring,fatigue, falling asleep and day-time sleepiness. Physical examination of the neck, chest and hip circumference,and height was performed. Information concerning physical training, co-morbid diseases, smoking and alcoholic consumption was collected.Results: The prevalence of snoring was 58.5, and 4.8% met the PMK OSA Questionnaire criteria, thus indicating a high risk of OSA. The information obtained indicated that laryngopharyngeal reflux(LPR), current smoking and alcoholic consumption were significantly higher in the high-risk OSA group.Conclusions: Early detection and treatment of OSA in active-duty army personnel are imperative. Physical examination and polysomnography can be used to reveal the high-risk group. High body mess index(BMI), laryngopharyngeal reflux, current smoking and alcoholic consumption are modifiable factors for OSA and are avoidable. A policy to decrease the BMI and risk of LPR, as well as to stop smoking and alcoholic consumption, should be applied.
Background: It is crucial for the army to know the prevalence of obstructive sleep apnea(OSA) syndrome in activeduty army personnel. Little information has been reported on the prevalence of OSA and clinical features in activeduty army personnel. This study was aimed to estimate the prevalence of snoring and risk of developing OSA in activeduty army personnel in Thailand and to identify the co-morbidities of OSA. In total, 1107 participants who were aged20–60 years and were deployed to the three southernmost provinces of Thailand were enrolled. All the participants completed the Phramongkutklao(PMK) Hospital OSA Questionnaire that was modified and validated from the Berlin Questionnaire and underwent physical examination. The participants were 1107 active-duty army personnel in the three southernmost provinces of Thailand, both males and females, aged 20–60 years.Methods: The PMK OSA Questionnaire was used to assess the risk of OSA together with interviewing for snoring,fatigue, falling asleep and day-time sleepiness. Physical examination of the neck, chest and hip circumference,and height was performed. Information concerning physical training, co-morbid diseases, smoking and alcoholic consumption was collected.Results: The prevalence of snoring was 58.5, and 4.8% met the PMK OSA Questionnaire criteria, thus indicating a high risk of OSA. The information obtained indicated that laryngopharyngeal reflux(LPR), current smoking and alcoholic consumption were significantly higher in the high-risk OSA group.Conclusions: Early detection and treatment of OSA in active-duty army personnel are imperative. Physical examination and polysomnography can be used to reveal the high-risk group. High body mess index(BMI), laryngopharyngeal reflux, current smoking and alcoholic consumption are modifiable factors for OSA and are avoidable. A policy to decrease the BMI and risk of LPR, as well as to stop smoking and alcoholic consumption, should be applied.
Background: It is crucial for the army to know the prevalence of obstructive sleep apnea(OSA) syndrome in activeduty army personnel. Little information has been reported on the prevalence of OSA and clinical features in activeduty army personnel. This study was aimed to estimate the prevalence of snoring and risk of developing OSA in activeduty army personnel in Thailand and to identify the co-morbidities of OSA. In total, 1107 participants who were aged20–60 years and were deployed to the three southernmost provinces of Thailand were enrolled. All the participants completed the Phramongkutklao(PMK) Hospital OSA Questionnaire that was modified and validated from the Berlin Questionnaire and underwent physical examination. The participants were 1107 active-duty army personnel in the three southernmost provinces of Thailand, both males and females, aged 20–60 years.Methods: The PMK OSA Questionnaire was used to assess the risk of OSA together with interviewing for snoring,fatigue, falling asleep and day-time sleepiness. Physical examination of the neck, chest and hip circumference,and height was performed. Information concerning physical training, co-morbid diseases, smoking and alcoholic consumption was collected.Results: The prevalence of snoring was 58.5, and 4.8% met the PMK OSA Questionnaire criteria, thus indicating a high risk of OSA. The information obtained indicated that laryngopharyngeal reflux(LPR), current smoking and alcoholic consumption were significantly higher in the high-risk OSA group.Conclusions: Early detection and treatment of OSA in active-duty army personnel are imperative. Physical examination and polysomnography can be used to reveal the high-risk group. High body mess index(BMI), laryngopharyngeal reflux, current smoking and alcoholic consumption are modifiable factors for OSA and are avoidable. A policy to decrease the BMI and risk of LPR, as well as to stop smoking and alcoholic consumption, should be applied.
引文
1.Amra B,Dorali R,Mortazavi S,Golshan M,Farajzadegan Z,Fietze I, et al.Sleep apnea symptoms and accident risk factors in Persian commercial vehicle drivers.Sleep Breath.201 2;16:187-19.
2.Babson KA,Del Re AC,Bonn-Miller MO,Woodward SH.The comorbidity of sleep apnea and mood,anxiety,and substance use disorders among obese military veterans within the veterans health administration.J Clin Sleep Med.2013;9(12):1 253-8.
3.Capaldi VF 2nd,Guerrero ML,Killgore WD.Sleep disruptions among returning combat veterans from Iraq and Afg hanistan.Mil Med.2011;176(8):879-88.
4.Kristo DA,Lettieri CJ,Abranda T,Taylor Y,Eliasson AH.Silent upper airway resistance syndrome:prevalence in a mixed milita ry population.Chest. 2005;127:1654-7.
5.Wright KP Jr,Bogan RK,Wyatt JK.Shift work and the assessment and management of shift work disorder(SWD).Sleep Med Rev.2013;17:41-54.
6.Okpala N,Walker R,Hosni A.Prevalence of snoring and sleepdisordered breathing among military personnel.Mil Med.2011;179(5):561-4.
7.Omachi TA,Claman DM,Blanc PD,Eisner MD.Obstructive sleep apnea:a risk factor for work disability.Sleep.2009;32(6):791-8.
8.Mysliwiec V,Gill J,Lee H,Baxter T,Pierce R,Barr TL,et al.Sleep disorders in US military personnel a high rate of comorbid insomnia and obstructive sleep apnea.Chest.2013;144(2):549-57.
9.Mysliwiec V,McGraw L,Pierce R,Smith P,Trapp B,Roth BJ.Sleep disorders and associated medical comorbidities in active duty military personnel.Sleep.201 3;36(2):1 67-74.
10. Ozer C,Etcibasi S,Ozturk L.Daytime sleepiness and sleep habits as risk factors of traffic accidents in a group of Turkish public transport drivers.Int J Clin Exp Med.201 4;7(1):268-73.
11.Stavaras C,Pastaka C,Papala M,Gravas S,Tzortzis V,Melekos M,et al. Sexual function in pre-and post-menopausal women with obstructive sleep apnea syndrome.Int J Impot Res.2012;24:228-33.
12.Baldwin CM,Bell IR,Guerra S,Quan SF.Obstructive sleep apnea and ischemic heart disease in southwestern US veterans:implications for clinical practice.Sleep Breath.2005;9(3):111-8.
13.Sharma SK,Vasudev C,Sinha S,Banga A,Pandey RM,Handa KK.Validation of the modified Berlin questionnaire to identify patients at risk fo r the obstructive sleep apnoea syndrome.Indian J Med Res.2006;124:281-90.
14.Sharma SK,Kumpawat S,Banga A,Goel A.Prevalence and risk factors of obstructive sleep apnea syndrome in a population of Delhi,India.Chest.2006;1 3:149-56.
15.Hiestand DM,Britz P,Goldman M,Phillios B.Prevalence of symptoms and risk of sleep apnea in the us population:results from the national sleep foundation sleep in America 2005 poll.Chest.2006;130(3):780-6.
16.Morinaga Y,Matsumura K,Kansui Y,Sakata S,Goto K,Haga Y,et al. Impact of obstructive sleep apnea on blood pressure and cardiovascular risk factors in Japanese men:a cross-sectional study in work-site group.Clin Exp Hypertens.2018;40(1):73-8.
17.Anuntaseree W,Rookkapan K,Kuasirikul S,Thongsuksai P,Snoring and obstructive sleep apnea in Thai school-age children:prevalance and predisposing factors.Pediatr Pulmonol.2001;32:222-7.
18.Kongsomboon K,Neruntarat C.Sleep-disordered breathing and risk factors in Thailand.Asia Biomed.2001;5(4):519-23.
19.Lee CL,Eun YG,Shin SY,Kim SW.Prevalence of snoring and high risk of obstructive sleep apnea syndrome in young male soldiers in Korea.J Korean Med Sci.2013;28:1373-7.
20.Banhiran W,Assanasen P,Nopmaneejumruslers C,Metheetrairut C.Epworth sleepiness scale in obstructive sleep disordered breathing:the reliability and validity of the Thai version.Sleep Breath.2011;15(3):571-7.
21.Onen F,Moreau T,Gooneratne NS,Petit C,Falissard B,Onen SH.Limits of the Epworth sleepiness scale in older adults.Sleep Breath.2013;17(1):343-50.
22.Lee SJ,Kana HW,Lee LH.The relationship between theEpworth sleepiness scale and polysomnographic parameter:in obstructive sleep apnea patients.Eur Arch Otorhinolaryngol2011;269(4):1143-7.
23.Ungtrakoon N.Reliability of Thai Berlin questionnaire to evaluate the risk of OSA in stroke patients.Srinagarind Med J.201 6;26:102,
24.Chung F,Subramanyam R,Liao P,Sasaki E,Shapiro C, Sun Y.High STOPbang score indicates a high probability of obstructive sleep apnoea.Br J Anaesth.201 2;108(5):768-75.
25.Suksakorn S,Rattanaumpawan P,Banhiran W,Cherakul N Chotinaiwattarakul W.Reliability and validity of Thai versior of the Berlin questionnaire in patients with sleep disordered breathing.J Med Assoc Thail.2014;6:46-56.
26.Banhiran W,Durongphan A,Saleesing C,Chongkolwatana C Diagnostic properties of the STOP-bang and its modified versior in screening for obstructive sleep apnea in Thai patients.J Med Assoc Thail.2014;97(6):644-54.
27.Frye JW, Vaezi MF.Extraesophageal GERD.Gastroenterol Clin N Am.2008;37(4):845-58.
28.Baroody F,Naclerio R.Cummings Otolaryngology(6th ed)Philadelphia:Elsevier;2015.
29.Thaikruea L,Seetamanotch W,Seetamanotch S.Appropriate cutoff level of BMI for screening in Thai adults.J Med Assoc Thail.2006;89(12):2123-8.
30.Appleton SL,Gill TK, Lang CJ,Taylor AW,McEvoy RD,Stocks NP,et al.Prevalence and comorbidity of sleep conditions in Australian adults:2016 sleep Health Foundation national survey.Sleep Health.2018;4(1):13-9.
31.Taveira KVM,Kuntze MM,Berretta F,de Souza BDM,Godolfim LR,Demathe T,De Luca Canto G,Porporatti AL.Association between obstructive sleep apnea and alcohol,caffeine and tobacco:a meta-analysis.J Oral Rehabil.201 8;42:39-46.
2.Babson KA,Del Re AC,Bonn-Miller MO,Woodward SH.The comorbidity of sleep apnea and mood,anxiety,and substance use disorders among obese military veterans within the veterans health administration.J Clin Sleep Med.2013;9(12):1 253-8.
3.Capaldi VF 2nd,Guerrero ML,Killgore WD.Sleep disruptions among returning combat veterans from Iraq and Afg hanistan.Mil Med.2011;176(8):879-88.
4.Kristo DA,Lettieri CJ,Abranda T,Taylor Y,Eliasson AH.Silent upper airway resistance syndrome:prevalence in a mixed milita ry population.Chest. 2005;127:1654-7.
5.Wright KP Jr,Bogan RK,Wyatt JK.Shift work and the assessment and management of shift work disorder(SWD).Sleep Med Rev.2013;17:41-54.
6.Okpala N,Walker R,Hosni A.Prevalence of snoring and sleepdisordered breathing among military personnel.Mil Med.2011;179(5):561-4.
7.Omachi TA,Claman DM,Blanc PD,Eisner MD.Obstructive sleep apnea:a risk factor for work disability.Sleep.2009;32(6):791-8.
8.Mysliwiec V,Gill J,Lee H,Baxter T,Pierce R,Barr TL,et al.Sleep disorders in US military personnel a high rate of comorbid insomnia and obstructive sleep apnea.Chest.2013;144(2):549-57.
9.Mysliwiec V,McGraw L,Pierce R,Smith P,Trapp B,Roth BJ.Sleep disorders and associated medical comorbidities in active duty military personnel.Sleep.201 3;36(2):1 67-74.
10. Ozer C,Etcibasi S,Ozturk L.Daytime sleepiness and sleep habits as risk factors of traffic accidents in a group of Turkish public transport drivers.Int J Clin Exp Med.201 4;7(1):268-73.
11.Stavaras C,Pastaka C,Papala M,Gravas S,Tzortzis V,Melekos M,et al. Sexual function in pre-and post-menopausal women with obstructive sleep apnea syndrome.Int J Impot Res.2012;24:228-33.
12.Baldwin CM,Bell IR,Guerra S,Quan SF.Obstructive sleep apnea and ischemic heart disease in southwestern US veterans:implications for clinical practice.Sleep Breath.2005;9(3):111-8.
13.Sharma SK,Vasudev C,Sinha S,Banga A,Pandey RM,Handa KK.Validation of the modified Berlin questionnaire to identify patients at risk fo r the obstructive sleep apnoea syndrome.Indian J Med Res.2006;124:281-90.
14.Sharma SK,Kumpawat S,Banga A,Goel A.Prevalence and risk factors of obstructive sleep apnea syndrome in a population of Delhi,India.Chest.2006;1 3:149-56.
15.Hiestand DM,Britz P,Goldman M,Phillios B.Prevalence of symptoms and risk of sleep apnea in the us population:results from the national sleep foundation sleep in America 2005 poll.Chest.2006;130(3):780-6.
16.Morinaga Y,Matsumura K,Kansui Y,Sakata S,Goto K,Haga Y,et al. Impact of obstructive sleep apnea on blood pressure and cardiovascular risk factors in Japanese men:a cross-sectional study in work-site group.Clin Exp Hypertens.2018;40(1):73-8.
17.Anuntaseree W,Rookkapan K,Kuasirikul S,Thongsuksai P,Snoring and obstructive sleep apnea in Thai school-age children:prevalance and predisposing factors.Pediatr Pulmonol.2001;32:222-7.
18.Kongsomboon K,Neruntarat C.Sleep-disordered breathing and risk factors in Thailand.Asia Biomed.2001;5(4):519-23.
19.Lee CL,Eun YG,Shin SY,Kim SW.Prevalence of snoring and high risk of obstructive sleep apnea syndrome in young male soldiers in Korea.J Korean Med Sci.2013;28:1373-7.
20.Banhiran W,Assanasen P,Nopmaneejumruslers C,Metheetrairut C.Epworth sleepiness scale in obstructive sleep disordered breathing:the reliability and validity of the Thai version.Sleep Breath.2011;15(3):571-7.
21.Onen F,Moreau T,Gooneratne NS,Petit C,Falissard B,Onen SH.Limits of the Epworth sleepiness scale in older adults.Sleep Breath.2013;17(1):343-50.
22.Lee SJ,Kana HW,Lee LH.The relationship between theEpworth sleepiness scale and polysomnographic parameter:in obstructive sleep apnea patients.Eur Arch Otorhinolaryngol2011;269(4):1143-7.
23.Ungtrakoon N.Reliability of Thai Berlin questionnaire to evaluate the risk of OSA in stroke patients.Srinagarind Med J.201 6;26:102,
24.Chung F,Subramanyam R,Liao P,Sasaki E,Shapiro C, Sun Y.High STOPbang score indicates a high probability of obstructive sleep apnoea.Br J Anaesth.201 2;108(5):768-75.
25.Suksakorn S,Rattanaumpawan P,Banhiran W,Cherakul N Chotinaiwattarakul W.Reliability and validity of Thai versior of the Berlin questionnaire in patients with sleep disordered breathing.J Med Assoc Thail.2014;6:46-56.
26.Banhiran W,Durongphan A,Saleesing C,Chongkolwatana C Diagnostic properties of the STOP-bang and its modified versior in screening for obstructive sleep apnea in Thai patients.J Med Assoc Thail.2014;97(6):644-54.
27.Frye JW, Vaezi MF.Extraesophageal GERD.Gastroenterol Clin N Am.2008;37(4):845-58.
28.Baroody F,Naclerio R.Cummings Otolaryngology(6th ed)Philadelphia:Elsevier;2015.
29.Thaikruea L,Seetamanotch W,Seetamanotch S.Appropriate cutoff level of BMI for screening in Thai adults.J Med Assoc Thail.2006;89(12):2123-8.
30.Appleton SL,Gill TK, Lang CJ,Taylor AW,McEvoy RD,Stocks NP,et al.Prevalence and comorbidity of sleep conditions in Australian adults:2016 sleep Health Foundation national survey.Sleep Health.2018;4(1):13-9.
31.Taveira KVM,Kuntze MM,Berretta F,de Souza BDM,Godolfim LR,Demathe T,De Luca Canto G,Porporatti AL.Association between obstructive sleep apnea and alcohol,caffeine and tobacco:a meta-analysis.J Oral Rehabil.201 8;42:39-46.