Body Mass Index and obstructive sleep apnoea. Wall H, et al Prim Care Respir J 2012;21(4):371-6
ABSTRACT: Body Mass Index and obstructive sleep apnoea
BACKGROUND: An increasing prevalence of obesity in the UK has also seen a rise in the diagnosis of co-morbidities. Obstructive sleep apnoea (OSA) has previously been associated with body mass index (BMI) but has not been fully explored in a UK population.
AIMS: To quantify the association between BMI and a recorded diagnosis of OSA in primary care for people aged 50 years or over in the UK.
METHODS: A descriptive analysis is given of men and women aged 50 or over in the UK from The Health Improvement Network (THIN) database with regard to diagnosis of OSA, snoring, and BMI. Logistic regression was performed for the likelihood of OSA depending on BMI classification recorded after adjusting for gender, age, region, and socioeconomic status (Townsend quintile). The analyses were repeated for snoring. Results: After adjusting for confounders, those with a BMI recorded of 40+ kg/m2 were 27.39 times (95% CI 24.64 to 30.46) more likely to have OSA (p<0.0001). There was a lower prevalence of OSA with increasing age and levels of deprivation.
CONCLUSIONS: Obesity and snoring were both strongly associated with a diagnosis of OSA. The decreasing prevalence of OSA with increasing age and levels of deprivation needs further study to ensure that these groups are not being systematically under-investigated.
COMMENT: Body Mass Index and Obstructive Sleep Apnoea. Although GP’s should certainly be alert to the possibility of OSA in obese patients, they should also be aware that fully 40% of sleep apnoea is diagnosed in people with a BMI <30. The danger of over-associating OSA with obesity and therefore ignoring it in the non-obese cannot be overstated. Bottom line: Don’t dismiss the possibility of OSA or snoring-related sleep disturbance in someone just because they aren’t overweight. (Bryn Sparks)
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