Sleep disordered breathing in four resource-limited settings in Peru: Prevalence, risk factors, and association with chronic diseases

CRONICAS Cohort Study Group

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Study Objectives: Sleep disordered breathing (SDB) is a highly prevalent condition in high-income countries, with major consequences for cardiopulmonary health, public safety, healthcare utilization, and mortality. However, its prevalence and effect in low-and middle-income countries are less well known. We sought to determine the prevalence, risk factors, and comorbidities of SDB symptoms in four resource-limited settings. Design: Cross-sectional analysis of the CRONICAS Cohort, a population-based age-and sex-stratified sample. Setting: Four resource-limited settings in Peru varying in altitude, urbanization, and air pollution. Participants: There were 2,682 adults aged 35 to 92 y. Measurements and Results: Self-reported SDB symptoms (habitual snoring, observed apneas, Epworth Sleepiness Scale), sociodemographics, medical history, anthropometrics, spirometry, blood biomarkers were reported. We found a high prevalence of habitual snoring (30.2%, 95% confidence interval [CI] 28.5-32.0%), observed apneas (20.9%, 95% CI 19.4-22.5%) and excessive daytime sleepiness (18.6%, 95% CI 17.1-20.1%). SDB symptoms varied across sites; prevalence and adjusted odds for habitual snoring were greatest at sea level, whereas those for observed apneas were greatest at high altitude. In multivariable analysis, habitual snoring was associated with older age, male sex, body mass index (BMI), and higher socioeconomic status; observed apneas were associated with BMI; and excessive daytime sleepiness was associated with older age, female sex, and medium socioeconomic status. Adjusted odds of cardiovascular disease, depression, and hypertension and total chronic disease burden increased progressively with the number of SDB symptoms. A threefold increase in the odds of having an additional chronic comorbid disease (adjusted odds ratio 3.57, 95% CI 2.18-5.84) was observed in those with all three versus no SDB symptoms. Conclusions: Sleep disordered breathing symptoms were highly prevalent, varied widely across four resource-limited settings in Peru, and exhibited strong independent associations with chronic diseases.

Original languageEnglish (US)
Pages (from-to)1451-1459B
JournalSleep
Volume38
Issue number9
DOIs
StatePublished - Sep 1 2015

Fingerprint

Peru
Sleep Apnea Syndromes
Chronic Disease
Snoring
Apnea
Confidence Intervals
Social Class
Body Mass Index
Urbanization
Spirometry
Air Pollution
Oceans and Seas
Comorbidity
Cardiovascular Diseases
Public Health
Cross-Sectional Studies
Biomarkers
Odds Ratio
Hypertension
Delivery of Health Care

Keywords

  • Chronic diseases
  • Population-based study
  • Sleep disordered breathing

ASJC Scopus subject areas

  • Physiology (medical)
  • Clinical Neurology

Cite this

Sleep disordered breathing in four resource-limited settings in Peru : Prevalence, risk factors, and association with chronic diseases. / CRONICAS Cohort Study Group.

In: Sleep, Vol. 38, No. 9, 01.09.2015, p. 1451-1459B.

Research output: Contribution to journalArticle

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abstract = "Study Objectives: Sleep disordered breathing (SDB) is a highly prevalent condition in high-income countries, with major consequences for cardiopulmonary health, public safety, healthcare utilization, and mortality. However, its prevalence and effect in low-and middle-income countries are less well known. We sought to determine the prevalence, risk factors, and comorbidities of SDB symptoms in four resource-limited settings. Design: Cross-sectional analysis of the CRONICAS Cohort, a population-based age-and sex-stratified sample. Setting: Four resource-limited settings in Peru varying in altitude, urbanization, and air pollution. Participants: There were 2,682 adults aged 35 to 92 y. Measurements and Results: Self-reported SDB symptoms (habitual snoring, observed apneas, Epworth Sleepiness Scale), sociodemographics, medical history, anthropometrics, spirometry, blood biomarkers were reported. We found a high prevalence of habitual snoring (30.2{\%}, 95{\%} confidence interval [CI] 28.5-32.0{\%}), observed apneas (20.9{\%}, 95{\%} CI 19.4-22.5{\%}) and excessive daytime sleepiness (18.6{\%}, 95{\%} CI 17.1-20.1{\%}). SDB symptoms varied across sites; prevalence and adjusted odds for habitual snoring were greatest at sea level, whereas those for observed apneas were greatest at high altitude. In multivariable analysis, habitual snoring was associated with older age, male sex, body mass index (BMI), and higher socioeconomic status; observed apneas were associated with BMI; and excessive daytime sleepiness was associated with older age, female sex, and medium socioeconomic status. Adjusted odds of cardiovascular disease, depression, and hypertension and total chronic disease burden increased progressively with the number of SDB symptoms. A threefold increase in the odds of having an additional chronic comorbid disease (adjusted odds ratio 3.57, 95{\%} CI 2.18-5.84) was observed in those with all three versus no SDB symptoms. Conclusions: Sleep disordered breathing symptoms were highly prevalent, varied widely across four resource-limited settings in Peru, and exhibited strong independent associations with chronic diseases.",
keywords = "Chronic diseases, Population-based study, Sleep disordered breathing",
author = "{CRONICAS Cohort Study Group} and Schwartz, {Noah G.} and Adi Rattner and Schwartz, {Alan R.} and Babak Mokhlesi and Gilman, {Robert H.} and Antonio Bernabe-Ortiz and Miranda, {J. Jaime} and William Checkley and Casas, {Juan P.} and Smith, {George Davey} and Shah Ebrahim and Garc{\'i}a, {H{\'e}ctor H.} and Luis Huicho and Germ{\'a}n M{\'a}laga and Montori, {Victor Manuel} and Liam Smeeth and Diette, {Gregory B.} and Fabiola Le{\'o}n-Velarde and Mar{\'i}a Rivera and Wise, {Robert A.} and Katherine Sacksteder",
year = "2015",
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AU - CRONICAS Cohort Study Group

AU - Schwartz, Noah G.

AU - Rattner, Adi

AU - Schwartz, Alan R.

AU - Mokhlesi, Babak

AU - Gilman, Robert H.

AU - Bernabe-Ortiz, Antonio

AU - Miranda, J. Jaime

AU - Checkley, William

AU - Casas, Juan P.

AU - Smith, George Davey

AU - Ebrahim, Shah

AU - García, Héctor H.

AU - Huicho, Luis

AU - Málaga, Germán

AU - Montori, Victor Manuel

AU - Smeeth, Liam

AU - Diette, Gregory B.

AU - León-Velarde, Fabiola

AU - Rivera, María

AU - Wise, Robert A.

AU - Sacksteder, Katherine

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Study Objectives: Sleep disordered breathing (SDB) is a highly prevalent condition in high-income countries, with major consequences for cardiopulmonary health, public safety, healthcare utilization, and mortality. However, its prevalence and effect in low-and middle-income countries are less well known. We sought to determine the prevalence, risk factors, and comorbidities of SDB symptoms in four resource-limited settings. Design: Cross-sectional analysis of the CRONICAS Cohort, a population-based age-and sex-stratified sample. Setting: Four resource-limited settings in Peru varying in altitude, urbanization, and air pollution. Participants: There were 2,682 adults aged 35 to 92 y. Measurements and Results: Self-reported SDB symptoms (habitual snoring, observed apneas, Epworth Sleepiness Scale), sociodemographics, medical history, anthropometrics, spirometry, blood biomarkers were reported. We found a high prevalence of habitual snoring (30.2%, 95% confidence interval [CI] 28.5-32.0%), observed apneas (20.9%, 95% CI 19.4-22.5%) and excessive daytime sleepiness (18.6%, 95% CI 17.1-20.1%). SDB symptoms varied across sites; prevalence and adjusted odds for habitual snoring were greatest at sea level, whereas those for observed apneas were greatest at high altitude. In multivariable analysis, habitual snoring was associated with older age, male sex, body mass index (BMI), and higher socioeconomic status; observed apneas were associated with BMI; and excessive daytime sleepiness was associated with older age, female sex, and medium socioeconomic status. Adjusted odds of cardiovascular disease, depression, and hypertension and total chronic disease burden increased progressively with the number of SDB symptoms. A threefold increase in the odds of having an additional chronic comorbid disease (adjusted odds ratio 3.57, 95% CI 2.18-5.84) was observed in those with all three versus no SDB symptoms. Conclusions: Sleep disordered breathing symptoms were highly prevalent, varied widely across four resource-limited settings in Peru, and exhibited strong independent associations with chronic diseases.

AB - Study Objectives: Sleep disordered breathing (SDB) is a highly prevalent condition in high-income countries, with major consequences for cardiopulmonary health, public safety, healthcare utilization, and mortality. However, its prevalence and effect in low-and middle-income countries are less well known. We sought to determine the prevalence, risk factors, and comorbidities of SDB symptoms in four resource-limited settings. Design: Cross-sectional analysis of the CRONICAS Cohort, a population-based age-and sex-stratified sample. Setting: Four resource-limited settings in Peru varying in altitude, urbanization, and air pollution. Participants: There were 2,682 adults aged 35 to 92 y. Measurements and Results: Self-reported SDB symptoms (habitual snoring, observed apneas, Epworth Sleepiness Scale), sociodemographics, medical history, anthropometrics, spirometry, blood biomarkers were reported. We found a high prevalence of habitual snoring (30.2%, 95% confidence interval [CI] 28.5-32.0%), observed apneas (20.9%, 95% CI 19.4-22.5%) and excessive daytime sleepiness (18.6%, 95% CI 17.1-20.1%). SDB symptoms varied across sites; prevalence and adjusted odds for habitual snoring were greatest at sea level, whereas those for observed apneas were greatest at high altitude. In multivariable analysis, habitual snoring was associated with older age, male sex, body mass index (BMI), and higher socioeconomic status; observed apneas were associated with BMI; and excessive daytime sleepiness was associated with older age, female sex, and medium socioeconomic status. Adjusted odds of cardiovascular disease, depression, and hypertension and total chronic disease burden increased progressively with the number of SDB symptoms. A threefold increase in the odds of having an additional chronic comorbid disease (adjusted odds ratio 3.57, 95% CI 2.18-5.84) was observed in those with all three versus no SDB symptoms. Conclusions: Sleep disordered breathing symptoms were highly prevalent, varied widely across four resource-limited settings in Peru, and exhibited strong independent associations with chronic diseases.

KW - Chronic diseases

KW - Population-based study

KW - Sleep disordered breathing

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