Sleep apnea syndrome in a young cosmopolite urban adult population: risk factors for disease severity.

PURPOSE: The purpose of this study is to investigate the risk factors for obstructive sleep apnea (OSA) in young patients from an urban European city with many migrants.

METHODS

The medical data of 2,343 patients referred for polysomnography from January 2007 till September 2009 were retrospectively reviewed in order to identify patients younger than 40 years with OSA and assess their characteristics.

RESULTS

One hundred twenty-one of the 2,093 patients (6%) referred for diagnostic polysomnography were younger than 40 years and had OSA. There were 17 women and 104 men. The race was Caucasian in 55% (67/121) and African in 42% (51/121). The median apnea-hypopnea index (AHI) was 39 in men and 23 in women (p < 0.01), 30 in Caucasians and 39 in Africans (p = 0.03). BMI was positively correlated to the AHI (correlation of 0.19, p = 0.04). Multiple regression modeling showed that African origin (p = 0.01), current smoking (p = 0.05), and neck circumference (p < 0.01) were predictors of AHI, independently of BMI, but not the presence of upper airway abnormalities (p = 0.75). Co-morbidities were frequent (hypertension, 20%; diabetes, 13%; hypercholesterolemia, 27%; depression, 13%; reflux and gastric ulcer, 13%; hypothyroidism, 5%; asthma, 9%), and were related to BMI (p = 0.02), nocturnal desaturation time (p = 0.02), and African origin (p = 0.024).

CONCLUSIONS

In patients aged <40 years and suffering from OSA, disease severity was associated with high BMI, large neck circumference, male sex, and African origin. After adjustment for BMI, African origin, tobacco use, and neck circumference remained predictors of high AHI. Neither upper airway abnormalities nor co-morbidities were found to be a risk factor for higher AHI in this group of young patients from a European city.