Hypertension in Cameroon associated with high likelihood of obstructive sleep apnea: a pilot study

Abstract

BackgroundAlthough disordered sleep patterns predispose to hypertension (HTN), little is known on the effect of the latter on sleep patterns in sub-Saharan Africa. This study therefore sought to generate preliminary data on the likelihood (risk) of Obstructive sleep apnea (OSA) in hypertensive patients, with the aid of sleep questionnaires.MethodsThis case–control study, age-and-sex-matched HTN patients with normotensive participants, and compared sleep patterns in either group determined with the aid of the Berlin Questionnaire (BQ) and Epworth Sleepiness Scale (ESS).ResultsOverall, 50 HTN and 54 age- and sex-matched normotensive participants were enrolled. The prevalence of snoring was higher in participants with hypertension compared to normotensives (58.0% versus 44.0% respectively), though not significantly, (p = 0.167). However, the hypertensive cases (aged on average 54.78 ± 8.79 years and with mean duration since diagnosis of 4.46 ± 4.36 years) had a significantly higher likelihood of Obstructive Sleep Apnea (OSA) than the controls (aOR = 5.03; 95% CI, 1.90–13.33, p = 0.001) and but no significant resulting daytime sleepiness (p = 0.421). There was no clear trend observed between both the risk of OSA and daytime sleepiness and HTN severity. Although not significant, participants with controlled hypertension had lower rates of risk of OSA compared to those with uncontrolled HTN (50.0% versus 63.2%, p = 0.718).ConclusionsPreliminary findings of this study (the first of its kind in Cameroon) suggests that hypertension is positively associated with likelihood of OSA in Cameroon. Further studies are required to investigate this further and the role of sleep questionnaires in our setting, cheap and easy to use tools which can be used to identify early, patients with hypertension in need for further sleep investigations. This will contribute to improving their quality of life and adherence to anti-hypertension treatment.

Obstructive sleep apnea and hypopnea syndrome in patients admitted in a tertiary hospital in Cameroon: Prevalence and associated factors

“…The prevalence of high risk of OSAHS we found in the present study using the STOP--BANG questionnaire is as high as previously reported by Sharma et al in 2015, in a study including obese patients admitted in a department of internal medicine [14]. In another study conducted by Njamnshi et al in Cameroon, 60% of patients with hypertension treated as outpatients were found to have a high risk of OSAHS using the Berlin questionnaire [25]. In the present study including patients with several comorbidities, the risk of OSAHS was found to be much higher than that assessed in the general population using the same questionnaire; namely 17.8% in Cameroon [10] or 36.9% in Nigeria [9].…”

Sleep Apnea Syndrome: Prevalence and Comorbidity with Other Non-communicable Diseases and HIV Infection, among Hospitalized Patients in Yaoundé, Cameroon

“…This association has been described in several studies in epidemiological western studies [ 4 , 5 , 47 ]. More recently in our setting, Njamnshi et al reported 60% of hypertension in patients with HR-OSAS and only 20% in patients with no risk [ 19 ], while we found 75.4% in patients with confirmed SAS. Surprisingly, we found no association between SAS and metabolic comorbidities, and obesity and diabetes were even more frequent in non-MS-SAS than in MS-SAS.…”

“…Balkissou et al found a SDB rate of 28.5% among an adult sample in Cameroon [ 13 ], while Benjafield et al's epidemiological estimation was 36.7% for Cameroon [ 16 ]. Besides those population-based data, hospital-based or clinical studies showed higher rates: 50%-77% for HR-OSAS in Nigeria and Cameroon [ 17 – 19 ] and 57.7% for SDB in Cameroon [ 20 ].…”

Higher Apnea-Hypopnea Index (AHI) and Oxygen Desaturation Index (ODI) Were Independently Associated with Increased Risks of Hypertension in Patients with T2DM: A Cross-Sectional Study

“…Hypertension is a globally public health problem, and OSAS is one of its modifiable risk factors [ 11 , 12 ]. Some studies found that there was a significantly positive association between hypertension and OSAS [ 13 , 14 ]. The prevalence of OSAS is approximately 30–40% in hypertensive patients [ 15 ].…”