Obstructive Sleep Apnea: Evaluation of high risk individuals, knowledge and associated factors among a representative sample of Lebanese adults

Abstract

Background: To date, there has been no large population-based study about Obstructive Sleep Apnea (OSA) in Lebanon. Our study evaluated high risk individuals, knowledge and associated factors of OSA among a representative sample of Lebanese adults. Methods: A cross-sectional study, conducted between June and August 2019, enrolled 472 people aged above 18. A proportionate random sample from all Lebanese Governorate was applied. Each governorate is divided into Caza (stratum), which in turn is divided into multiple villages. Two villages were selected randomly from the list of villages provided by the Central Agency of Statistics in Lebanon. Households were randomly selected from each village using an online software.Results: The percentage of physician-diagnosed sleep apnea in our sample was 11%; 159 (33.7%) had poor knowledge (scores ≤11), whereas 165 (35.0%) and 148 (31.4%) had moderate (scores between 12 and 15) and good (scores ≥16) knowledge respectively. The study results showed that -according to the Epworth Scale- having diabetes mellitus, myocardial infarction, arrhythmia, and hypertension were associated with higher daytime sleepiness. Furthermore, mild, moderate and severe excessive daytime sleepiness (EDS) percentages were 14.4%, 16.3% and 13.8% respectively. According to the STOP-BANG questionnaire, 31.6% of participants had an intermediate risk of OSA and 7.6% had a high risk. Diabetic patients and those with myocardial infarction were significantly associated with higher STOP BANG scores.Concerning knowledge, having heard about sleep apnea was associated with a higher knowledge score. Overall, 31.4% of the participants had a good score. Conclusion The actual study proves that EDS which has adverse health effects, is associated with multiple morbidities. Besides, the general population isn’t aware enough of this disease. Comparing the rate of high-risk individuals to the physician-diagnosed ones, we conclude that in Lebanon, OSA is likely prevalent but underdiagnosed. Ongoing health campaigns and screenings should be assigned to target the general community.