Quality of sleep and risk for obstructive sleep apnoea in ambulant individuals with type 2 diabetes mellitus at a tertiary referral hospital in Kenya: a cross-sectional, comparative study.
Quality of sleep and risk for obstructive sleep apnoea in ambulant individuals with type 2 diabetes mellitus at a tertiary referral hospital in Kenya: a cross-sectional, comparative study.
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DOI：
10.1186/s12902-017-0158-6
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发表时间：
2017-02-06
影响因子：
2.7
通讯作者：
Mutai KK
中科院分区：
文献类型：
--
作者：
Sokwalla SM;Joshi MD;Amayo EO;Acharya K;Mecha JO;Mutai KK
睡眠障碍很常见，并与多种代谢和心理紊乱有关。阻塞性睡眠呼吸暂停（OSA）是最常见的睡眠障碍之一，OSA与胰岛素抵抗、肥胖、2型糖尿病（T2DM）和心血管疾病之间存在相互关系。肯尼亚人，特别是2型糖尿病患者的睡眠障碍患病率尚不清楚。因此，我们旨在确定T2DM患者中睡眠质量差（QOS）和OSA高风险的患病率，并确定其与社会人口学和人体测量变量的关系。采用横断面描述性设计，在随机选择的T2DM患者样本（例）和年龄和性别匹配的对照组中确定QOS和OSA风险。采用经验证的匹兹堡睡眠质量指数（PSQI）和柏林问卷（BQ）分别衡量OSA的QOS和风险。评估了低QOS、OSA高风险与病例中社会人口统计学和人体测量变量之间的关系。随机选择245名18岁以上门诊就诊的T2DM患者，其中22人因不合格而被排除，223人被纳入分析；53.8%为女性，平均年龄56.8岁（SD 12.2），平均BMI为28.8 kg/m2 （SD 4.4）。其中，QOS较差119例（53%,CI 95% 46.5 ~ 60.2）， OSA高危99例（44% CI 95% 37.8 ~ 50.9）。对照组112例患者中，33例（29.5%，CI为20.9 ~ 38.3）存在较差的QOS， 9例（8%，CI为3.3 ~ 13.4）存在OSA高危。患者出现较差QOS的概率[OR为2.76 (95% CI为1.7-4.4)]和出现OSA的高风险[OR为9.1 (95% CI为4.4-19.0)]的概率明显较高。在某些情况下，较高的腰围与OSA的高风险独立相关。我们证明了T2DM患者睡眠障碍的高负担。我们的研究结果可能对临床医生在评估T2DM患者时筛查睡眠障碍有启示，并值得这一领域的从业人员和研究人员进一步关注。本文的在线版本（doi:10.1186/s12902-017-0158-6）包含补充材料，可供授权用户使用。
Sleep disorders are common and associated with multiple metabolic and psychological derangements. Obstructive sleep apnoea (OSA) is among the most common sleep disorders and an inter-relationship between OSA, insulin resistance, obesity, type 2 diabetes (T2DM) and cardiovascular diseases has been established. Prevalence of sleep disorders in Kenyans, particularly in individuals with T2DM is unknown. We thus aimed to determine prevalence of poor quality of sleep (QOS) and high risk for OSA, among persons with T2DM and determine their associations with socio-demographic and anthropometric variables. Utilising a Cross- Sectional Descriptive design, QOS and risk for OSA were determined in a randomly selected sample of patients with T2DM (cases) and an age and sex matched comparison group. The validated Pittsburgh Sleep Quality Index (PSQI) and Berlin Questionnaire (BQ) were used to measure QOS and risk for OSA respectively. Associations between poor QOS, high risk for OSA, and socio-demographic and anthropometric variables in cases were evaluated. From 245 randomly selected persons with T2DM attending outpatient clinics, aged over 18 years, 22 were excluded due to ineligibility thus 223 were included in the analysis; 53.8% were females, mean age was 56.8 (SD 12.2) years and mean BMI was 28.8 kg/m2 (SD 4.4). Among them, 119 (53%, CI 95% 46.5–60.2) had poor QOS and 99 (44% CI 95% 37.8–50.9) were at high risk for OSA. Among 112 individuals in comparison group, 33 (29.5%, CI 95% 20.9–38.3) had poor QOS and 9 (8%, CI 95% 3.3–13.4) had high risk for OSA. Cases had a significantly higher probability for poor QOS [OR 2.76 (95% CI 1.7–4.4))] and high risk for OSA [OR 9.1 (95% CI 4.4–19.0)]. Higher waist circumference was independently associated with a high risk for OSA in cases. We demonstrate a high burden of sleep disturbances in patients with T2DM. Our findings may have implications for clinicians to screen for sleep disorders when assessing patients with T2DM and warranting further attention by practitioners and researches in this field. The online version of this article (doi:10.1186/s12902-017-0158-6) contains supplementary material, which is available to authorized users.