prevalence of obstructive sleep apnea in a sample of Egyptian railway drivers

Abstract

Background: There are scanty international and even no Egyptian studies addressing the prevalence of obstructive sleep apnea syndrome (OSAS) in railway drivers with an expected high risk for accidents. Thus, it is worth studying and assessing the prevalence and predictors of OSAS among Egyptian railway drivers.

Patients and methods: This prospective cross-sectional screening study was conducted on 160 Egyptian railway drivers. They were subjected to medical history taking and examination, anthropometric measurements, oxygen saturation (SPO2) by oximetry, arterial blood gases, Friedman obstructive sleep apnea-hypopnea syndrome (OSAHS) score measurement, and Arabic version of both Berlin and STOP-BANG questionnaires. Then, limited night polysomnography (PSG) was done in the high-risk patients. Finally, full channels PSG was done for positive limited night PSG.  

Results: The prevalence of sleep apnea among the studied cases was 4.22%. There was high statistically significant difference between non-OSAS group and OSAS group regarding age ≤ 49ys (OR =11.364), witnessed apneas during sleep (OR=175), weight in kg > 95(OR=13.00), PaO₂ ≤ 88 (OR=31.0), PaCo₂ > 39 (OR=31.0) and average SPO₂≤88(OR =34.0). Regarding parameters of limited night PSG, AHI cut off point was ≥ 5  and area under the curve (AUC) of 100.0%, O₂ desaturation index cut off point was  > 17.2 and AUC of 100%, lastly, the average SPO₂ cut off point was ≤ 88%  and AUC of 76.4%.

Conclusion: This study highlights for the first time the prevalence of OSAS was 4.2% in a sample studied of Egyptian railway drivers. Our results further point that weight, neck circumference, systolic blood pressure, PaO₂, and Paco₂ are the most useful predictors of suspecting OSAS. Also, parameters of limited PSG are considered a useful tool in confirming the suspected patients with OSAS.