Primary care diabetes · 2025
High prevalence of undiagnosed obstructive sleep apnoea in older adults with suboptimally-controlled type 2 diabetes and comorbid insomnia.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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O Chun Kwan, Chan Rachel Ny, Chan Ka Pang, Wu Hongjiang, Lam Fanny Mf, Lee Hester Hc, Chow Elaine Yk, Luk Andrea Oy, Ma Ronald Cw, Wing Yun Kwok, Chan Juliana Cn, Kong Alice Ps
Аннотация
BACKGROUND: We aimed to explore the prevalence of and clinical factors that identify obstructive sleep apnoea (OSA) in older adults with suboptimally-controlled type 2 diabetes (T2D) and comorbid insomnia.
METHODS: In this cross-sectional analysis, participants had age≥ 60 years, HbA1c7.5-10 % and comorbid insomnia [insomnia severity index (ISI)> 14] with no prior history of OSA. All participants had home sleep apnoea testing done to measure apnoea-hypopnea index (AHI) and completed questionnaires including self-reporting of habitual snoring (≥3 nights/week), Four-Variable Screening Tool (FVST) comprising sex, body mass index (BMI), blood pressure and frequency of snoring, and excessive daytime sleepiness (EDS) [Epworth Sleepiness Scale (ESS) score ≥ 10]. Mild, moderate, and severe OSA were defined by AHI 5 to < 15, ≥ 15 to < 30, and ≥ 30 events/hour respectively.
RESULTS: Among 93 participants(mean age: 68.3 ± 4.8 years, 46 % men, BMI:24.8 ± 3.7 kg/m2), 87 % had OSA (43 % moderate-to-severe OSA) and 41.8 % had EDS. A diagnosis of OSA was associated with BMI[odd ratio(OR)1.233(95 %CI:1.015-1.498),p = 0.035], habitual snoring[8.107(2.192-29.977), p = 0.002], and FVST[1.386(1.132-1.698), p = 0.002]. The cut-off value of FVST≥ 5 or ESS≥ 10 had 100 % sensitivity and 20.8 (9.8-31.7)% specificity to detect moderate-to-severe OSA.
CONCLUSIONS: Older adults with suboptimally-controlled T2D and comorbid insomnia had high prevalence of undiagnosed OSA with FVST and EDS as potentially useful screening tools.
METHODS: In this cross-sectional analysis, participants had age≥ 60 years, HbA1c7.5-10 % and comorbid insomnia [insomnia severity index (ISI)> 14] with no prior history of OSA. All participants had home sleep apnoea testing done to measure apnoea-hypopnea index (AHI) and completed questionnaires including self-reporting of habitual snoring (≥3 nights/week), Four-Variable Screening Tool (FVST) comprising sex, body mass index (BMI), blood pressure and frequency of snoring, and excessive daytime sleepiness (EDS) [Epworth Sleepiness Scale (ESS) score ≥ 10]. Mild, moderate, and severe OSA were defined by AHI 5 to < 15, ≥ 15 to < 30, and ≥ 30 events/hour respectively.
RESULTS: Among 93 participants(mean age: 68.3 ± 4.8 years, 46 % men, BMI:24.8 ± 3.7 kg/m2), 87 % had OSA (43 % moderate-to-severe OSA) and 41.8 % had EDS. A diagnosis of OSA was associated with BMI[odd ratio(OR)1.233(95 %CI:1.015-1.498),p = 0.035], habitual snoring[8.107(2.192-29.977), p = 0.002], and FVST[1.386(1.132-1.698), p = 0.002]. The cut-off value of FVST≥ 5 or ESS≥ 10 had 100 % sensitivity and 20.8 (9.8-31.7)% specificity to detect moderate-to-severe OSA.
CONCLUSIONS: Older adults with suboptimally-controlled T2D and comorbid insomnia had high prevalence of undiagnosed OSA with FVST and EDS as potentially useful screening tools.