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Published on: December 6, 2016
Obstructive sleep apnea syndrome: are we missing an at-risk population?
Christopher J Lettieri1, Am H Eliasson, Teotimo Andrada
1Pulmonary, Critical Care and Sleep Medicine Service, Walter Reed Army Medical Center, Washington, DC 20307, USA. christopher.lettieri@us.army.mil
Insights
Obstructive sleep apnea syndrome (OSAS) affects individuals of all ages and weights. This study found that OSAS severity is not dependent on age or body mass index (BMI), even in younger, less obese populations.
Area of Science:
- Sleep Medicine
- Pulmonology
- Internal Medicine
Background:
- Obstructive sleep apnea syndrome (OSAS) is commonly associated with older age and higher body-mass index (BMI).
- Preconceived notions about typical OSAS patients can lead to underdiagnosis in younger, non-overweight individuals.
- This study investigated the relationship between OSAS severity, age, and BMI in a diverse population, including active-duty military personnel.
Purpose of the Study:
- To test the hypothesis that OSAS severity is independent of age and BMI in a younger, less obese population.
- To evaluate potential differences in OSAS prevalence and severity across different demographic groups (active-duty military, National Guardsmen, civilians).
Main Methods:
- A prospective study included 270 consecutive patients diagnosed with OSAS.
- Demographic data, including age and BMI, were collected for active-duty military members, National Guardsmen, and civilians.
- Correlation between age, BMI, and OSAS severity (apnea-hypopnea index - AHI) was analyzed.
Main Results:
- Active-duty military personnel were significantly younger and had lower BMIs compared to National Guardsmen and civilians.
- Despite demographic differences, the prevalence of severe OSAS did not vary significantly between the groups.
- No significant correlation was found between BMI and OSAS severity in active-duty subjects; a weak correlation existed between age and AHI across all subjects.
Conclusions:
- Obstructive sleep apnea syndrome (OSAS) can occur in young, non-obese individuals.
- Excessive daytime sleepiness warrants consideration for OSAS, irrespective of patient age or BMI.
- Clinical awareness of OSAS in diverse populations is crucial for accurate diagnosis and management.
Study Objectives:
While age and body-mass index (BMI) are well-established risk factors for obstructive sleep apnea syndrome (OSAS), this disorder occurs across a wide spectrum of ages and weights. Preconceptions regarding "classic" patients with OSAS may lead to underdiagnosis in at-risk populations, particularly younger nonoverweight individuals. We hypothesized that the severity of OSAS is independent of age and BMI in a younger less-obese population.
Methods:
Prospective study of consecutive patients diagnosed with OSAS. Active-duty military, National Guardsmen, and civilians were compared to determine if age and BMI correlated with disease severity.
Results:
Two hundred seventy subjects (120 active-duty, 80 National Guardsmen, 70 civilians) were included. Active-duty military members were significantly younger and less overweight than both National Guardsmen and civilians. Of the civilians, 64.3% and, of National Guardsmen, 48.8% were obese, whereas only 19.2% of active-duty had a BMI > or = 30 kg/m2 (p < .001). However, the prevalence of severe disease did not differ between groups. Disease severity showed no correlation with BMI among active-duty subjects (r = 0.09, p = .33). Of the active-duty subjects, 37.5% had severe disease, as compared with 42.5% of National Guard and 45.7% of civilian subjects (p = .18 and .09, respectively). BMI did not differ between active-duty subjects with severe disease and those with mild to moderate OSAS (26.7 kg/m2 versus 26.9 kg/m2, p = .40). There was a low but significant correlation between age and AHI (r = 0.21, p = .02) among all subjects.
Conclusions:
OSAS occurs in young nonobese individuals and should be considered in patients reporting excessive daytime sleepiness, regardless of age or BMI.
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