Prevalence, sleep characteristics, and comorbidities in a population at high risk for obstructive sleep apnea: A nationwide questionnaire study in South Korea

Sunwoo, Jun Sang; Hwangbo, Young; Kim, Won Joo; Chu, Min Kyung; Yun, Chang-Ho; Yang, Kwang Ik

doi:10.1371/journal.pone.0193549

Cited by 47 publications

(32 citation statements)

References 72 publications

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“…Thus, our data support the hypothesis that the prevalence estimates for no, mild, or moderate sleep apnea among those with STOP-Bang scores of 3 and 4 may be evenly balanced [37] and that STOP-Bang threshold at 4 may be more useful in the general population [38]. This may partially explain a somewhat higher rate of sleep apnea with a cut-off value at ≥3 (34.2%) in our study population compared to other studies [39]. …”

Section: Discussionsupporting

confidence: 85%

“…Also similar to our results, the association of BMI and some of mental component dimensions of HRQoL were found in OSA patients [ 55 ]. Evidence indicate that BMI and depression may contribute to sleep difficulties [ 34 , 39 , 56 ]. Our data also showed that depression symptoms were significantly higher in subjects with poor sleep quality, daytime sleepiness, OSA risk, and insomnia, which was to be expected.…”

Section: Discussionmentioning

confidence: 99%

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Relationship between Sleep Disorders and Health Related Quality of Life—Results from the Georgia SOMNUS Study

Darchia

Oniani

Sakhelashvili

et al. 2018

IJERPH

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The extent to which sleep disorders are associated with impairment of health-related quality of life (HRQoL) is poorly described in the developing world. We investigated the prevalence and severity of various sleep disorders and their associations with HRQoL in an urban Georgian population. 395 volunteers (20–60 years) completed Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, STOP-Bang questionnaire, Insomnia Severity Index, Beck Depression Inventory-Short Form, and Short Form Health Survey (SF-12). Socio-demographic data and body mass index (BMI) were obtained. The prevalence of sleep disorders and their association with HRQoL was considerable. All SF-12 components and physical and mental component summaries (PCS, MCS) were significantly lower in poor sleepers, subjects with daytime sleepiness, apnea risk, or insomnia. Insomnia and apnea severity were also associated with lower scores on most SF-12 dimensions. The effect of insomnia severity was more pronounced on MCS, while apnea severity—on PCS. Hierarchical analyses showed that after controlling for potential confounding factors (demographics, depression, BMI), sleep quality significantly increased model’s predictive power with an R2 change (ΔR2) by 3.5% for PCS (adjusted R2 = 0.27) and by 2.9% for MCS (adjusted R2 = 0.48); for the other SF-12 components ΔR2 ranged between 1.4% and 4.6%. ESS, STOP-Bang, ISI scores, all exerted clear effects on PCS and MCS in an individual regression models. Our results confirm and extend the findings of studies from Western societies and strongly support the importance of sleep for HRQoL. Elaboration of intervention programs designed to strengthen sleep-related health care and thereof HRQoL is especially important in the developing world.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Relationship between Sleep Disorders and Health Related Quality of Life—Results from the Georgia SOMNUS Study

Darchia

Oniani

Sakhelashvili

et al. 2018

IJERPH

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“…Thus, we suggest that breaking every 4 hours should be practiced to prevent drowsy-related accidents. High risk of OSA in the BQ was reported in 57.3% of participating CMV drivers, higher compared with 19.8% of the general male population of Korea [30]. This proportion is consistent with results of recent studies reporting prevalence of suspected OSA in CMV drivers ranging between 26% and 56% [31][32][33].…”

Section: Discussionsupporting

confidence: 90%

Sleep Status and the Risk Factor of Drowsy-Related Accidents in Commercial Motor Vehicle Drivers

et al. 2018

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Background and ObjectiveaaThe purpose of this study was to describe prevalence of sleep problems including obstructive sleep apnea (OSA), insomnia, and sleep insufficiency in commercial motor vehicle (CMV) drivers, and to quantify risk of drowsy-related accidents in CMV drivers. MethodsaaCMV drivers were invited to participate in this study. Participants were asked to complete a questionnaire about sleep habits, sleep disorders, work environments, and experience of drowsy-related accidents. A home sleep test (Watch-PAT 200) was also undertaken to detect OSA. resultsaaAmong 110 participants, 89 with eligible data of questionnaires and home sleep tests were included in the analysis. 91.0% of participants had OSA with peripheral arterial tonometry respiratory distress index (pRDI) ≥ 5/h and 23.6% had moderate to severe OSA with pRDI ≥ 15/h. 55.1% perceived that their sleep is insufficient. 52.3% of participants experienced drowsy driving. Drowsy driving-related motor vehicle crashes (MVCs) and near miss MVCs were reported by 9.6% and 37.9% of participants, respectively. Multiple regression analysis showed that increased risk of drowsy driving was associated with perceived sleep insufficiency [odds ratio (OR) = 3.48, 95% confidence interval (CI) 1.26-9.64]. Increased risk of drowsy driving-related near miss MVC was associated with perceived sleep insufficiency (OR = 3.06, 95% CI 1.11-8.44) and continuous driving for more than 4 hours (OR = 3.10, 95% CI 1.00-9.58). ConclusionsaaOSA and perceived sleep insufficiency are prevalent in CMV drivers. Perceived sleep insufficiency and longer continuous driving hours increased risk of drowsy-related accidents.

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“…Our survey also did not collect information on sleep quality [ 44 ] and sleep disorder [ 45 ] and thus we were not able to account for these variables in our analysis. Individuals with sleep disorder such as sleep apnea and insomnia are more likely to have shorter sleep duration [ 46 , 47 ] and higher risk of all-cause mortality [ 46 – 50 ]. Therefore, failure to take account of diagnosis and treatment of sleep disorder may lead to overestimation of positive association between short sleep and mortality.…”

Section: Discussionmentioning

confidence: 99%

Sleep duration and mortality in Korean adults: a population-based prospective cohort study

Kwon

Lee

et al. 2020

BMC Public Health

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Background Increasing evidence suggests that sleep duration is associated with risks of various diseases including type 2 diabetes, cardiovascular disease (CVD), and certain types of cancer. However, the relationship with mortality is not clear, particularly in non-European populations. In this study, we investigated the association between sleep duration and mortality in a population-based prospective cohort of Korean adults. Methods This analysis included 34,264 participants (14,704 men and 19,560 women) of the Korea National Health and Nutrition Examination Survey (KNHANES) 2007–2013 who agreed to mortality follow-up through December 31, 2016. Sleep duration was self-reported at baseline and was categorized into four groups: ≤4, 5–6, 7–8, and ≥ 9 h/day. Cox proportional hazards models were performed to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the associations with mortality (all-cause as well as CVD- and cancer-specific), adjusting for potential confounders. Results During up to 9.5 years of follow-up, we identified a total of 1028 deaths. We observed the lowest mortality at 5–6 h/day sleep. Compared with 7–8 h/day of sleep, short (≤4 h/day) and long (≥9 h/day) sleep were associated with a 1.05-fold (95% CI = 0.79–1.39) and 1.47-fold (95% CI = 1.15–1.87) higher all-cause mortality, respectively. After additional adjustment for self-rated health, the positive association with short sleep disappeared (HR = 0.99, 95% CI = 0.75–1.32) and the association with long sleep was slightly attenuated (HR = 1.38, 95% CI = 1.08–1.76). Long sleep was also nonsignificantly positively associated with both cancer-mortality (HR = 1.30, 95% CI = 0.86–1.98) and CVD-mortality (HR = 1.27, 95% CI = 0.73–2.21). There was no statistically significant evidence for nonlinearity in the relationships between sleep duration and mortality (all-cause as well as CVD- and cancer-specific). Effect modification by age, sex, education, and occupation were not statistically significant. Conclusions Our findings suggest that long sleep duration is associated with an increased all-cause mortality in Korean adults.

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Prevalence, sleep characteristics, and comorbidities in a population at high risk for obstructive sleep apnea: A nationwide questionnaire study in South Korea

Cited by 47 publications

References 72 publications

Relationship between Sleep Disorders and Health Related Quality of Life—Results from the Georgia SOMNUS Study

Relationship between Sleep Disorders and Health Related Quality of Life—Results from the Georgia SOMNUS Study

Sleep Status and the Risk Factor of Drowsy-Related Accidents in Commercial Motor Vehicle Drivers

Sleep duration and mortality in Korean adults: a population-based prospective cohort study

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