Prevalence of and risk factors for obstructive syndrome apnea

Obstructive Sleep Apnea Syndrome (OSAS) is becoming an important public health problem because of its frequency and adverse health consequences. The objective of this prospective study was to evaluate the prevalence of and risk factors for OSA in a cohort of subjects working for the french Army.

This prospective study was carried out on a sample of volunteers working for the French army. The subjects were recruited at their annual work visit between November 2008 and September 2009. Subjects were asked to complete 2 screening questionnaires (Epworth and Berlin) and were given a medical examination. Subjects suspected of having OSAS (based on high questionnaire scores) were monitored by nocturnal ventilatory polygraphy. OSAS was diagnosed if the subject was found to have an apnea/hypopnea index (AHI) greater than or equal to 5.

In this healthy, young and active population (n = 1054), 4.20% of subjects were diagnosed with OSA. Comparing our two groups of subjects (OSA and non-OSA), several statistically significant (p < .05) differences emerged that may be associated with OSA: the individuals with OSA were older by an average of 7 years, they presented with an average BMI greater than 4.5 kg/m2, an average abdominal girth greater than 12.2 cm and an average cervical circumference greater than 2.6 cm. In addition, they consumed more tobacco when they were smokers and were more likely to present with permanent nasal obstruction. They were also more likely to suffer from gastroesophageal reflux and present with skeletal class II. Finally, they presented with a longer average soft palate as determined by the Mallampati scoring system.

We found that the major risk factors for OSAS were age, BMI, abdominal girth and cervical circumference (linear correlations determined by bi-variate analysis).